Provider Demographics
NPI:1952444697
Name:HOLCZER, REVA ERICA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REVA
Middle Name:ERICA
Last Name:HOLCZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3203
Mailing Address - Country:US
Mailing Address - Phone:212-947-7111
Mailing Address - Fax:516-564-0239
Practice Address - Street 1:235 MAPLE ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3203
Practice Address - Country:US
Practice Address - Phone:212-947-7111
Practice Address - Fax:516-564-0239
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037374-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical