Provider Demographics
NPI:1902939176
Name:ROTHAUSER, CARYN RACHEL (LCSW)
Entity type:Individual
Prefix:MS
First Name:CARYN
Middle Name:RACHEL
Last Name:ROTHAUSER
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 1:514 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2010
Mailing Address - Country:US
Mailing Address - Phone:718-437-5234
Mailing Address - Fax:
Practice Address - Street 1:781 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1723
Practice Address - Country:US
Practice Address - Phone:718-993-1400
Practice Address - Fax:718-993-0647
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0782371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical