Provider Demographics
NPI:1386678969
Name:KRASNOFF, ARLEEN (LCSWR)
Entity type:Individual
Prefix:
First Name:ARLEEN
Middle Name:
Last Name:KRASNOFF
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BUSHVILLE SWAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12734-5415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 COMMUNITY LANE
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-0716
Practice Address - Country:US
Practice Address - Phone:845-292-8770
Practice Address - Fax:845-292-4206
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO34903104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00398370Medicaid