Provider Demographics
NPI:1487787156
Name:ZORFAS SPIVAK, JUDITH S (LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:S
Last Name:ZORFAS SPIVAK
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 1:31 W 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5661
Mailing Address - Country:US
Mailing Address - Phone:212-501-7726
Mailing Address - Fax:212-595-9121
Practice Address - Street 1:31 W 82ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5661
Practice Address - Country:US
Practice Address - Phone:212-501-7726
Practice Address - Fax:212-595-9171
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041754-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR041754-1OtherNY SOCIAL WORK LICENSE