=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386877553
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLIFFORD P FRANK LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2009
-----------------------------------------------------
Last Update Date | 09/03/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 585 SCHENECTADY AVE PSYCHIATRY DEPARTMENT
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11203-1891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-604-4795
-----------------------------------------------------
Fax | 718-604-5468
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 585 SCHENECTADY AVE PSYCHIATRY DEPARTMENT
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11203-1891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-604-5239
-----------------------------------------------------
Fax | 718-604-5468
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 070640
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------