Healthcare Provider Details

I. General information

NPI: 1891914255
Provider Name (Legal Business Name): RANDY FRANKEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 ASHLAND PL SUITE 12 D
BROOKLYN NY
11201-3974
US

IV. Provider business mailing address

125 ASHLAND PL SUITE 12 D
BROOKLYN NY
11201-3974
US

V. Phone/Fax

Practice location:
  • Phone: 917-751-1942
  • Fax: 718-624-5629
Mailing address:
  • Phone: 917-751-1942
  • Fax: 718-624-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR020835-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: