Healthcare Provider Details

I. General information

NPI: 1184040750
Provider Name (Legal Business Name): ERICA HAUBEN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 12/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 HILL BLVD
YORKTOWN HEIGHTS NY
10598-1283
US

IV. Provider business mailing address

593 JOHN ST
PEEKSKILL NY
10566-2129
US

V. Phone/Fax

Practice location:
  • Phone: 914-352-6116
  • Fax: 914-352-6117
Mailing address:
  • Phone: 504-638-2553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10376
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number087896
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: