Healthcare Provider Details

I. General information

NPI: 1912678988
Provider Name (Legal Business Name): ROMANAXEL KRASSNER LCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BROADWAY # 11984
ALBANY NY
12207-2922
US

IV. Provider business mailing address

418 BROADWAY # 11984
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 516-646-1516
  • Fax: 516-751-2110
Mailing address:
  • Phone: 516-646-1516
  • Fax: 516-751-2110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103677
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116684
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: