Provider Demographics
NPI:1407508484
Name:AGASKAR, VAIBHAVEE (PH D)
Entity Type:Individual
Prefix:
First Name:VAIBHAVEE
Middle Name:
Last Name:AGASKAR
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:DR
Other - First Name:VAIBHAVEE
Other - Middle Name:
Other - Last Name:GADRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:15 WARREN ST APT 407
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-6459
Mailing Address - Country:US
Mailing Address - Phone:248-250-0833
Mailing Address - Fax:
Practice Address - Street 1:15 WARREN ST APT 407
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-6459
Practice Address - Country:US
Practice Address - Phone:248-250-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00624400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional