Provider Demographics
NPI:1891865234
Name:LUGO, ADA NAVIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ADA
Middle Name:NAVIA
Last Name:LUGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6222
Mailing Address - Country:US
Mailing Address - Phone:718-299-3045
Mailing Address - Fax:718-716-2604
Practice Address - Street 1:4123 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6222
Practice Address - Country:US
Practice Address - Phone:718-299-3045
Practice Address - Fax:718-716-2604
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY136167177OtherFIDELIS