Provider Demographics
NPI:1144420498
Name:YANKELEVICH, IRIS S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:S
Last Name:YANKELEVICH
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 1:7235 112TH ST
Mailing Address - Street 2:APT. 12C
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5469
Mailing Address - Country:US
Mailing Address - Phone:718-896-5615
Mailing Address - Fax:718-576-2693
Practice Address - Street 1:10915 QUEENS BLVD
Practice Address - Street 2:LL
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5482
Practice Address - Country:US
Practice Address - Phone:718-896-5615
Practice Address - Fax:718-576-2693
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0798931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical