Provider Demographics
NPI:1043464688
Name:PRADIER, YVONNE J (LMSW)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:J
Last Name:PRADIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 WEXFORD TER
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3050
Mailing Address - Country:US
Mailing Address - Phone:917-838-9473
Mailing Address - Fax:
Practice Address - Street 1:17810 WEXFORD TER
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3050
Practice Address - Country:US
Practice Address - Phone:917-838-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072935-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical