Healthcare Provider Details

I. General information

NPI: 1306478839
Provider Name (Legal Business Name): RACHEL B STRAX-HABER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL B STRAX LCSW

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24302 NORTHERN BLVD
LITTLE NECK NY
11362-1199
US

IV. Provider business mailing address

1053 TOTTEN ST
WHITESTONE NY
11357-2846
US

V. Phone/Fax

Practice location:
  • Phone: 718-423-6200
  • Fax:
Mailing address:
  • Phone: 718-820-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107439
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097732
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: