Provider Demographics
NPI:1134932361
Name:YASSKY, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:YASSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3374 PERRY FROW DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5042
Mailing Address - Country:US
Mailing Address - Phone:561-251-5164
Mailing Address - Fax:
Practice Address - Street 1:810 7TH AVE FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5923
Practice Address - Country:US
Practice Address - Phone:212-290-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health