Provider Demographics
NPI:1548696958
Name:FROMMER, TZIVIA B (LMSW)
Entity type:Individual
Prefix:
First Name:TZIVIA
Middle Name:B
Last Name:FROMMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FAIRWAY OVAL
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1723
Mailing Address - Country:US
Mailing Address - Phone:845-617-4529
Mailing Address - Fax:
Practice Address - Street 1:14 FAIRWAY OVAL
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1723
Practice Address - Country:US
Practice Address - Phone:845-617-4529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083033104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker