Provider Demographics
NPI:1316055643
Name:ISRAEL, AMY (LMSW)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:728 N MAIN ST
Mailing Address - Street 2:REFUAH HEALTH CENTER
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1960
Mailing Address - Country:US
Mailing Address - Phone:845-354-9300
Mailing Address - Fax:845-354-9448
Practice Address - Street 1:728 N MAIN ST
Practice Address - Street 2:REFUAH HEALTH CENTER
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1960
Practice Address - Country:US
Practice Address - Phone:845-354-9300
Practice Address - Fax:845-354-9448
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01421705Medicaid