Provider Demographics
NPI:1285879601
Name:SANCHEZ, A RAQUEL (LCSW)
Entity type:Individual
Prefix:
First Name:A
Middle Name:RAQUEL
Last Name:SANCHEZ
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 1:465 SHORE ROAD
Mailing Address - Street 2:2R
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4440
Mailing Address - Country:US
Mailing Address - Phone:718-718-2112
Mailing Address - Fax:
Practice Address - Street 1:465 SHORE ROAD
Practice Address - Street 2:2R
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4440
Practice Address - Country:US
Practice Address - Phone:718-718-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046759-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNIU621Medicare PIN