Healthcare Provider Details

I. General information

NPI: 1285041483
Provider Name (Legal Business Name): ROCHELLE SAX LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2014
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 E 13TH ST
BROOKLYN NY
11230-3601
US

IV. Provider business mailing address

937 E 13TH ST
BROOKLYN NY
11230-3601
US

V. Phone/Fax

Practice location:
  • Phone: 718-377-5960
  • Fax:
Mailing address:
  • Phone: 718-377-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO19902-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberRO19902-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: