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General NPI Number Information
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NPI Number | 1972919389
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Entity Type | Individual
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Provider Name | REBECCA STAHL LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 853 BROADWAY STE 1401
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City | NEW YORK
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State | NY
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Zip | 10003-4716
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Country | US
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Telephone | 929-260-3324
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Fax |
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Provider Business Mailing Address
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Address Line | 461 DEAN ST APT 7B
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City | BROOKLYN
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State | NY
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Zip | 11217-4138
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Country | US
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Telephone | 973-202-8171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 090574
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 085951
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License Number State | NY
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