Provider Demographics
NPI:1841029568
Name:GUREWITSCH, NIVA (LMSW)
Entity type:Individual
Prefix:
First Name:NIVA
Middle Name:
Last Name:GUREWITSCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 E 90TH ST APT 7E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5173
Mailing Address - Country:US
Mailing Address - Phone:443-651-1618
Mailing Address - Fax:
Practice Address - Street 1:96 5TH AVE APT 1L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7604
Practice Address - Country:US
Practice Address - Phone:443-651-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106776104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker