Provider Demographics
NPI:1023184751
Name:HASNAS, JUDITH ANN (LCSW BCD)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:HASNAS
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E 55TH ST
Mailing Address - Street 2:APT 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5113
Mailing Address - Country:US
Mailing Address - Phone:516-781-6396
Mailing Address - Fax:516-409-8041
Practice Address - Street 1:412 E 55TH ST
Practice Address - Street 2:APT 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5113
Practice Address - Country:US
Practice Address - Phone:516-781-6396
Practice Address - Fax:516-409-8041
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02099611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN31082Medicare ID - Type Unspecified