Provider Demographics
NPI:1285273185
Name:LEIFMAN, HOWARD DAVID (CSW, PHD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:DAVID
Last Name:LEIFMAN
Suffix:
Gender:M
Credentials:CSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 1ST AVE
Mailing Address - Street 2:19S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3793
Mailing Address - Country:US
Mailing Address - Phone:917-951-6746
Mailing Address - Fax:
Practice Address - Street 1:630 1ST AVE
Practice Address - Street 2:19S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3793
Practice Address - Country:US
Practice Address - Phone:917-951-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1368881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical