Provider Demographics
NPI:1366527731
Name:RICE, LOIS (LCSW)
Entity type:Individual
Prefix:MS
First Name:LOIS
Middle Name:
Last Name:RICE
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 1:175 W 93RD ST
Mailing Address - Street 2:6D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9313
Mailing Address - Country:US
Mailing Address - Phone:212-666-3940
Mailing Address - Fax:
Practice Address - Street 1:315 HUDSON ST
Practice Address - Street 2:2ND FLOOR CLINIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1009
Practice Address - Country:US
Practice Address - Phone:917-606-6618
Practice Address - Fax:212-366-8144
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075565-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN69J623721Medicare ID - Type Unspecified