Provider Demographics
NPI:1851592943
Name:MORALES, IVETTE A (MSW)
Entity Type:Individual
Prefix:
First Name:IVETTE
Middle Name:A
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 UNDERHILL AVE APT 9G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2734
Mailing Address - Country:US
Mailing Address - Phone:347-597-5070
Mailing Address - Fax:
Practice Address - Street 1:2250 RYER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1104
Practice Address - Country:US
Practice Address - Phone:718-960-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical