Healthcare Provider Details

I. General information

NPI: 1568693885
Provider Name (Legal Business Name): ROCHELLE GUTTMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 KINGS HWY
BROOKLYN NY
11223-1629
US

IV. Provider business mailing address

1628 E 29TH ST
BROOKLYN NY
11229-2546
US

V. Phone/Fax

Practice location:
  • Phone: 718-787-1100
  • Fax: 718-787-9598
Mailing address:
  • Phone: 718-787-1100
  • Fax: 718-787-9598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number033026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: