Healthcare Provider Details

I. General information

NPI: 1811371107
Provider Name (Legal Business Name): HEATHER ROISER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 W 26TH ST FL 8
NEW YORK NY
10001-6700
US

IV. Provider business mailing address

226 WEST 26TH STREET 8TH FLOOR, OFFICE 5
NEW YORK NY
10001
US

V. Phone/Fax

Practice location:
  • Phone: 917-994-6958
  • Fax: 917-970-9468
Mailing address:
  • Phone: 917-994-6958
  • Fax: 917-970-9468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW16971
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number087449
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: