Provider Demographics
NPI:1962568055
Name:HENIK, LIBBY (LCSW)
Entity type:Individual
Prefix:MS
First Name:LIBBY
Middle Name:
Last Name:HENIK
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 1:7000 KENNEDY BLVD E
Mailing Address - Street 2:150B
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4818
Mailing Address - Country:US
Mailing Address - Phone:201-453-8746
Mailing Address - Fax:
Practice Address - Street 1:1225 PARK AVE
Practice Address - Street 2:1SC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1758
Practice Address - Country:US
Practice Address - Phone:212-560-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04947311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNOJ271Medicare ID - Type UnspecifiedLCSW