Provider Demographics
NPI:1407966187
Name:LUN, YVONNE P (LCSWR ACSW DCSW)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:P
Last Name:LUN
Suffix:
Gender:F
Credentials:LCSWR ACSW DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 W 66TH ST
Mailing Address - Street 2:#39B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-721-2867
Mailing Address - Fax:212-721-2867
Practice Address - Street 1:19 W 34TH ST
Practice Address - Street 2:PENTHOUSE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-947-7111
Practice Address - Fax:212-239-0948
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0442211101Y00000X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY62476635Medicaid
NY3465282OtherAETNA
P1997678OtherOXFORD
NY512647OtherVALUE OPTIONS
NYN1I621Medicare ID - Type Unspecified