Doctor Name: | PROF. ILENE ROBIN AUGENLICHT |
NPI Number: | 1124177472 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R040417-1 |
Business Practice Address: | 2539 Middle Country Rd Suite 4 Centereach, NY - 117203551 |
Business Phone Number: | 6314673848 |
Business Fax Number: | 6314514660 |
Mailing Address: | 28 Forrest Ave, CENTEREACH |
State: | NY |
Postal Code: | 117203639 |
Phone Number: | 6314673848 |
Fax Number: | 6314514660 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R040417-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |