Provider Demographics
NPI:1841560166
Name:VERHEY, JONATHAN JOSEPH (LCSW)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:JOSEPH
Last Name:VERHEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E RALEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2811
Mailing Address - Country:US
Mailing Address - Phone:917-968-1445
Mailing Address - Fax:
Practice Address - Street 1:1346 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3906
Practice Address - Country:US
Practice Address - Phone:917-968-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071375104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker