Provider Demographics
NPI:1134170921
Name:HEITNER, ESTHER ROSE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:ROSE
Last Name:HEITNER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 EAST 25TH ST. (3C)
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3075
Mailing Address - Country:US
Mailing Address - Phone:212-683-6644
Mailing Address - Fax:212-683-6644
Practice Address - Street 1:41-51 EAST 11 ST. (4TH FL.)
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4600
Practice Address - Country:US
Practice Address - Phone:212-683-6644
Practice Address - Fax:212-683-6644
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL73 0367831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9C 541Medicare ID - Type UnspecifiedPROVIDER NUMBER