Provider Demographics
NPI:1568791077
Name:KOENIGSBERG, YAEL (LMSW)
Entity Type:Individual
Prefix:
First Name:YAEL
Middle Name:
Last Name:KOENIGSBERG
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 1:480 W 187TH ST
Mailing Address - Street 2:APARTMENT 6J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1501
Mailing Address - Country:US
Mailing Address - Phone:305-532-7739
Mailing Address - Fax:
Practice Address - Street 1:18410 JAMAICA AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2400
Practice Address - Country:US
Practice Address - Phone:718-454-3584
Practice Address - Fax:718-454-3583
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker