Provider Demographics
NPI:1467054437
Name:YARBROUGH, MAGDALENA JUSTINE (LMSW)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:JUSTINE
Last Name:YARBROUGH
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 1:91 HALL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2506
Mailing Address - Country:US
Mailing Address - Phone:559-905-4020
Mailing Address - Fax:
Practice Address - Street 1:148 PARK PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3303
Practice Address - Country:US
Practice Address - Phone:718-398-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110772104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker