Healthcare Provider Details

I. General information

NPI: 1679100291
Provider Name (Legal Business Name): BLIMA SCHNEEBALG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ELM ST UNIT 201
SPRING VALLEY NY
10977-8314
US

IV. Provider business mailing address

10 ELM ST UNIT 201
SPRING VALLEY NY
10977-8314
US

V. Phone/Fax

Practice location:
  • Phone: 845-263-4854
  • Fax:
Mailing address:
  • Phone: 845-263-4854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number096146
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number109288
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: