Provider Demographics
NPI:1871968578
Name:SPIELBERGER, JOHN (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:SPIELBERGER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 SEAVIEW AVENUE
Mailing Address - Street 2:SOUTH BEACH PSYCHIATRIC CENTER
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-974-8164
Mailing Address - Fax:718-668-8070
Practice Address - Street 1:777 SEAVIEW AVE.
Practice Address - Street 2:SOUTH BEACH PSYCHIATRIC CENTER
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-974-8164
Practice Address - Fax:718-668-8070
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057344104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker