Provider Demographics
NPI:1740330349
Name:SCHUCART- RAVIV, LOIS (LCSW MA)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:
Last Name:SCHUCART- RAVIV
Suffix:
Gender:F
Credentials:LCSW MA
Other - Prefix:MRS
Other - First Name:LOIS
Other - Middle Name:SCHUCART
Other - Last Name:RAVIV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 GLEN STREET
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:513-759-0297
Mailing Address - Fax:
Practice Address - Street 1:70 GLEN STREET
Practice Address - Street 2:SUITE 250
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:513-759-0297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR253431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY143727OtherVALUE OPTIONS
NY7330688OtherGHI
NY7330688OtherGHI