Provider Demographics
NPI:1952531873
Name:ILOVITZ, MALKAH W (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:MALKAH
Middle Name:W
Last Name:ILOVITZ
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1529
Mailing Address - Country:US
Mailing Address - Phone:718-344-1745
Mailing Address - Fax:212-655-5436
Practice Address - Street 1:18 MIDDLETON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5415
Practice Address - Country:US
Practice Address - Phone:718-344-1745
Practice Address - Fax:212-655-5436
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR020090-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical