Provider Demographics
NPI:1265820922
Name:JAMES, VIDA (LMSW)
Entity Type:Individual
Prefix:
First Name:VIDA
Middle Name:
Last Name:JAMES
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 1:121 AVENUE OF THE AMERICAS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1510
Mailing Address - Country:US
Mailing Address - Phone:212-941-9090
Mailing Address - Fax:
Practice Address - Street 1:555 BROOME ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1510
Practice Address - Country:US
Practice Address - Phone:212-941-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health