Provider Demographics
NPI:1215939970
Name:MORALES, REBECCA (LCSW)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:MORALES
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 1:1463 WARING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5707
Mailing Address - Country:US
Mailing Address - Phone:917-304-5910
Mailing Address - Fax:
Practice Address - Street 1:1 STONE PL
Practice Address - Street 2:STE 305
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3427
Practice Address - Country:US
Practice Address - Phone:917-304-5910
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056901-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNP5141Medicare ID - Type UnspecifiedPSYCHOTHERAPIST