Provider Demographics
NPI:1336566751
Name:WASSER, JAMES M (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:WASSER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:YAAKOV
Other - Middle Name:M
Other - Last Name:WASSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:222 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2608
Mailing Address - Country:US
Mailing Address - Phone:917-789-0902
Mailing Address - Fax:
Practice Address - Street 1:1312 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3612
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health