Basic Information
| Provider Information | |||||||||
| NPI: | 1962676437 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEAUBOEUF-ROANE | ||||||||
| FirstName: | PASCALE | ||||||||
| MiddleName: | GENEVIEVE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW-R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 STONEWALL CIR | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106071804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145234977 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 115 W 31ST ST | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100013596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125646006 | ||||||||
| FaxNumber: | 2125643440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2008 | ||||||||
| LastUpdateDate: | 04/16/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 071062-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 12021 | MD | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.