Provider Demographics
NPI:1588712129
Name:KRAVEC,LCSW, STEPHANIE J (STEPHANIE KRAVEC,LCS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:KRAVEC,LCSW
Suffix:
Gender:F
Credentials:STEPHANIE KRAVEC,LCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1238 PELHAMDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-3302
Mailing Address - Country:US
Mailing Address - Phone:914-738-5989
Mailing Address - Fax:914-738-5989
Practice Address - Street 1:211 W 56TH ST
Practice Address - Street 2:SUITE 30H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4312
Practice Address - Country:US
Practice Address - Phone:212-315-3449
Practice Address - Fax:212-315-3449
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLR155011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical