Basic Information
| Provider Information | |||||||||
| NPI: | 1750465027 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERKOWITZ | ||||||||
| FirstName: | MARVIN | ||||||||
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| Credential: | PHD, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 780 W END AVE | ||||||||
| Address2: | 12 B | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100255573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126628666 | ||||||||
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| Practice Location | |||||||||
| Address1: | 80 VANDAM ST. | ||||||||
| Address2: | FEGS MANHATTAN COUNSELING CENTER, 2ND FL. | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123668096 | ||||||||
| FaxNumber: | 2123668144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R040262-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.