Provider Demographics
NPI:1124282223
Name:DRAKOS, ROXANNE (LCSW-R)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:DRAKOS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N PARSONAGE ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1200
Mailing Address - Country:US
Mailing Address - Phone:845-876-1984
Mailing Address - Fax:845-876-1984
Practice Address - Street 1:50 N PARSONAGE ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1200
Practice Address - Country:US
Practice Address - Phone:845-876-1984
Practice Address - Fax:845-876-1984
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0347641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9A121Medicare UPIN