Provider Demographics
NPI:1881994093
Name:GOLD RAPPS, LEAH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:GOLD RAPPS
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 1:11 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1216
Mailing Address - Country:US
Mailing Address - Phone:718-809-1708
Mailing Address - Fax:
Practice Address - Street 1:1312 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3612
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0771941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical