Provider Demographics
NPI:1134208234
Name:FRASCA, ADA M (LCSW-R MA)
Entity type:Individual
Prefix:MS
First Name:ADA
Middle Name:M
Last Name:FRASCA
Suffix:
Gender:F
Credentials:LCSW-R MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 108TH ST
Mailing Address - Street 2:4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2758
Mailing Address - Country:US
Mailing Address - Phone:212-665-3328
Mailing Address - Fax:
Practice Address - Street 1:200 W 108TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:917-696-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078745-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical