Provider Demographics
NPI:1275818718
Name:HERNANDEZ COLON, YAJAIRA (LMSW)
Entity Type:Individual
Prefix:
First Name:YAJAIRA
Middle Name:
Last Name:HERNANDEZ COLON
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 1:1282 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07062-2232
Mailing Address - Country:US
Mailing Address - Phone:929-396-6909
Mailing Address - Fax:
Practice Address - Street 1:1282 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07062-2232
Practice Address - Country:US
Practice Address - Phone:929-396-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103551104100000X
NY09433-011041C0700X
PR9745104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker