Provider Demographics
NPI:1063547487
Name:WINOGRAD, JOAN DIANE (LCSW,)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:DIANE
Last Name:WINOGRAD
Suffix:
Gender:F
Credentials:LCSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 W END AVE
Mailing Address - Street 2:APT. 10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1606
Mailing Address - Country:US
Mailing Address - Phone:212-362-4003
Mailing Address - Fax:212-362-4035
Practice Address - Street 1:140 RIVERSIDE DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2605
Practice Address - Country:US
Practice Address - Phone:212-362-4003
Practice Address - Fax:212-362-4035
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO27978-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical