Provider Demographics
NPI:1376368233
Name:SPUTZ, YEHUDA (LMSW)
Entity type:Individual
Prefix:
First Name:YEHUDA
Middle Name:
Last Name:SPUTZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BERDICHEV WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-8162
Mailing Address - Country:US
Mailing Address - Phone:845-587-4900
Mailing Address - Fax:
Practice Address - Street 1:6 BERDICHEV WAY
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-8162
Practice Address - Country:US
Practice Address - Phone:845-587-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL072104001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical