Provider Demographics
NPI:1275865818
Name:POLANCO-CASTILLO, YENY M (LCSW, CASAC)
Entity Type:Individual
Prefix:MRS
First Name:YENY
Middle Name:M
Last Name:POLANCO-CASTILLO
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NEWARK POMPTON TPKE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1632
Mailing Address - Country:US
Mailing Address - Phone:973-706-5207
Mailing Address - Fax:
Practice Address - Street 1:250 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5430
Practice Address - Country:US
Practice Address - Phone:917-645-0257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0696331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical