Provider Demographics
NPI:1386657682
Name:HABER, NAOMI RUTH (MSW)
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:RUTH
Last Name:HABER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 70TH ST
Mailing Address - Street 2:34K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4301
Mailing Address - Country:US
Mailing Address - Phone:212-721-1279
Mailing Address - Fax:212-496-1749
Practice Address - Street 1:185 WEST END AVENUE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-721-1279
Practice Address - Fax:212-496-1749
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR022743-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11236352OtherCAQH ID