Provider Demographics
NPI:1831667807
Name:HABIB, YASMIN (LMSW)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:HABIB
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 1:238 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-2504
Mailing Address - Country:US
Mailing Address - Phone:315-782-9450
Mailing Address - Fax:315-782-2643
Practice Address - Street 1:238 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2504
Practice Address - Country:US
Practice Address - Phone:315-782-9450
Practice Address - Fax:315-782-2643
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092400104100000X
NY0885331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker