Provider Demographics
NPI:1306260484
Name:SAMANTHA MANEWITZ, LCSW
Entity type:Organization
Organization Name:SAMANTHA MANEWITZ, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANEWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-457-7847
Mailing Address - Street 1:360 E 72ND ST
Mailing Address - Street 2:APT A1401
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4753
Mailing Address - Country:US
Mailing Address - Phone:212-734-4336
Mailing Address - Fax:
Practice Address - Street 1:360 E 72ND ST
Practice Address - Street 2:APT A1401
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4753
Practice Address - Country:US
Practice Address - Phone:212-734-4336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006879A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty