Provider Demographics
NPI:1144721713
Name:RUTKOVSKY, JULIA CRAWFORD (LCSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CRAWFORD
Last Name:RUTKOVSKY
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 1:401 E 80TH ST APT 20C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0651
Mailing Address - Country:US
Mailing Address - Phone:914-874-7363
Mailing Address - Fax:
Practice Address - Street 1:401 E 80TH ST APT 20C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0651
Practice Address - Country:US
Practice Address - Phone:914-874-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0930411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical