Provider Demographics
NPI:1407150840
Name:VESPREY, MAUDLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:MAUDLYN
Middle Name:
Last Name:VESPREY
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 1:483 MONTGOMERY ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3021
Mailing Address - Country:US
Mailing Address - Phone:347-563-3174
Mailing Address - Fax:347-365-7451
Practice Address - Street 1:483 MONTGOMERY ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3021
Practice Address - Country:US
Practice Address - Phone:347-563-3174
Practice Address - Fax:347-365-7451
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12022101YA0400X
NY072351-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)