MEDICARE: MRS. FABIENNE MARIE LESCOUFLAIR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	101655	NY

General Provider Information

NPI Number	:	1295305886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FABIENNE MARIE LESCOUFLAIR LCSW

Provider Business Mailing Address
First Line	:	2900 EXTERIOR ST STE 202
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7103
Country	:	US
Telephone Number	:	607-238-5357
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 EXTERIOR ST STE 202
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7103
Country	:	US
Telephone Number	:	607-238-5357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	01/06/2026

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