Healthcare Provider Details

I. General information

NPI: 1801934740
Provider Name (Legal Business Name): ROCHELLE BARBARA SOMER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 ARGYLE RD
CEDARHURST NY
11516-1105
US

IV. Provider business mailing address

364 ARGYLE RD
CEDARHURST NY
11516-1105
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-9360
  • Fax: 516-569-9462
Mailing address:
  • Phone: 516-295-9360
  • Fax: 516-569-9462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR021767-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02213289
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: