Provider Demographics
NPI:1891465910
Name:OSORIO, YANIRA (MHCLP)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:OSORIO
Suffix:
Gender:F
Credentials:MHCLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 E 161ST ST APT 9C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4388
Mailing Address - Country:US
Mailing Address - Phone:917-645-6922
Mailing Address - Fax:
Practice Address - Street 1:19 GREENRIDGE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1201
Practice Address - Country:US
Practice Address - Phone:914-949-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1810824501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health