Provider Demographics
NPI:1215281001
Name:ESCALERA, RAFAEL ESTEBAN (LMSW, CASAC-T)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:ESTEBAN
Last Name:ESCALERA
Suffix:
Gender:M
Credentials:LMSW, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3941
Mailing Address - Country:US
Mailing Address - Phone:347-558-1951
Mailing Address - Fax:
Practice Address - Street 1:4123 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6222
Practice Address - Country:US
Practice Address - Phone:718-299-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078497-11041C0700X
NY22712101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)