Provider Demographics
NPI:1740011238
Name:BLUME FRANKEL, STACEY (LMSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:BLUME FRANKEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:ILENE
Other - Last Name:BLUMENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:25 REYNOLDS LN
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3837
Mailing Address - Country:US
Mailing Address - Phone:917-449-1515
Mailing Address - Fax:
Practice Address - Street 1:25 REYNOLDS LN
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-3837
Practice Address - Country:US
Practice Address - Phone:917-449-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0661191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical