Provider Demographics
NPI:1720831431
Name:VERMA, JYOTI PRASAD (LMSW)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:PRASAD
Last Name:VERMA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14477 41ST AVE APT 418
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1432
Mailing Address - Country:US
Mailing Address - Phone:603-943-2004
Mailing Address - Fax:
Practice Address - Street 1:14477 41ST AVE APT 418
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1432
Practice Address - Country:US
Practice Address - Phone:603-943-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116299104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker