Provider Demographics
NPI:1982858346
Name:HABER, CLEO (LMSW)
Entity Type:Individual
Prefix:
First Name:CLEO
Middle Name:
Last Name:HABER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 PROSPECT PL
Mailing Address - Street 2:APT. 2D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4266
Mailing Address - Country:US
Mailing Address - Phone:917-843-2098
Mailing Address - Fax:
Practice Address - Street 1:333 E 115TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2210
Practice Address - Country:US
Practice Address - Phone:917-843-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073333-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker