Provider Demographics
NPI:1164606265
Name:YONLY, BEATRIC TINA (LMSW)
Entity Type:Individual
Prefix:
First Name:BEATRIC
Middle Name:TINA
Last Name:YONLY
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 1:100 STEVENS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2600
Mailing Address - Country:US
Mailing Address - Phone:917-981-7557
Mailing Address - Fax:914-663-4829
Practice Address - Street 1:100 STEVENS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2600
Practice Address - Country:US
Practice Address - Phone:917-981-7557
Practice Address - Fax:914-663-4829
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072379 1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker