Provider Demographics
NPI:1932248390
Name:BERKOWITZ-DELIN, STEPHANIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:BERKOWITZ-DELIN
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 1:140 ROXEN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1516
Mailing Address - Country:US
Mailing Address - Phone:516-536-8678
Mailing Address - Fax:516-536-8678
Practice Address - Street 1:100 N VILLAGE AVE
Practice Address - Street 2:SUITE # 25
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3767
Practice Address - Country:US
Practice Address - Phone:516-536-8678
Practice Address - Fax:516-536-8678
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO41511-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN56441Medicare PIN