Provider Demographics
NPI:1790033439
Name:KRISTEVA, JOANNA VANYA (PHD, LCSW, LISW)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:VANYA
Last Name:KRISTEVA
Suffix:
Gender:F
Credentials:PHD, LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BROADWAY STE 1605
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3756
Mailing Address - Country:US
Mailing Address - Phone:814-503-0986
Mailing Address - Fax:917-725-9299
Practice Address - Street 1:225 BROADWAY STE 1605
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3756
Practice Address - Country:US
Practice Address - Phone:212-693-4010
Practice Address - Fax:212-693-4014
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0871361041C0700X
OHI.21027171041C0700X
NY0844031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical