Provider Demographics
NPI:1740680008
Name:LOWENTHAL, LEORA S (LCSW)
Entity type:Individual
Prefix:MS
First Name:LEORA
Middle Name:S
Last Name:LOWENTHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 16TH ST APT 10H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3711
Mailing Address - Country:US
Mailing Address - Phone:917-584-4757
Mailing Address - Fax:
Practice Address - Street 1:200 E 16TH ST APT 10H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3711
Practice Address - Country:US
Practice Address - Phone:917-584-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2014-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0548751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical