Provider Demographics
NPI:1710509310
Name:SERUYA, ASHLEY M (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:SERUYA
Suffix:
Gender:X
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHER
Other - Middle Name:M
Other - Last Name:SERUYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:80 UNIVERSITY PL FL 2G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PL FL 2G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4564
Practice Address - Country:US
Practice Address - Phone:646-389-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical