Provider Demographics
NPI:1013991793
Name:USADI, EVA JACQUELINE (MA, BCD)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:JACQUELINE
Last Name:USADI
Suffix:
Gender:F
Credentials:MA, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 12TH STREET
Mailing Address - Street 2:#3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NM
Mailing Address - Zip Code:11215-5190
Mailing Address - Country:US
Mailing Address - Phone:718-832-2327
Mailing Address - Fax:
Practice Address - Street 1:26 WEST 9TH STREET
Practice Address - Street 2:SUITE 5E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8922
Practice Address - Country:US
Practice Address - Phone:212-532-6574
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045519-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical