Provider Demographics
NPI:1538904081
Name:RESNICK, BETH SUZANNE (LCSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:SUZANNE
Last Name:RESNICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:SUZANNE
Other - Last Name:RESNICK-FOLK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3 WENDOVER LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6823
Mailing Address - Country:US
Mailing Address - Phone:845-596-6519
Mailing Address - Fax:
Practice Address - Street 1:3 WENDOVER LN
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6823
Practice Address - Country:US
Practice Address - Phone:845-596-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093708-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical