Provider Demographics
NPI:1699489344
Name:REY, MANUEL (LCSW)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:REY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115-25 84TH AVENUE
Mailing Address - Street 2:APT 4H
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:917-355-1629
Mailing Address - Fax:
Practice Address - Street 1:310 E SHORE RD STE 100
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2432
Practice Address - Country:US
Practice Address - Phone:888-262-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078284-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical