Provider Demographics
NPI:1649557349
Name:BOBROFF, MIRIAM (LCSW)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:BOBROFF
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 1:28 CARLTON RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2521
Mailing Address - Country:US
Mailing Address - Phone:845-270-0219
Mailing Address - Fax:
Practice Address - Street 1:500 NEW HEMPSTEAD RD
Practice Address - Street 2:SUITE D
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-270-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036327-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical