Provider Demographics
NPI:1508918459
Name:TRAGER, JODI HEATHER (LCSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:HEATHER
Last Name:TRAGER
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 1:12 LIMESTONE RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2305
Mailing Address - Country:US
Mailing Address - Phone:914-772-3444
Mailing Address - Fax:
Practice Address - Street 1:12 LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2305
Practice Address - Country:US
Practice Address - Phone:914-772-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073081-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical