Provider Demographics
NPI:1366614026
Name:SCHIFFMAN, MARK (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:SCHIFFMAN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 LAKEFRONT RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-2226
Mailing Address - Country:US
Mailing Address - Phone:914-393-3454
Mailing Address - Fax:
Practice Address - Street 1:100 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2557
Practice Address - Country:US
Practice Address - Phone:914-393-3454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0716161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical