Healthcare Provider Details

I. General information

NPI: 1336705995
Provider Name (Legal Business Name): AMELIA LYNNE YANKEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2019
Last Update Date: 02/28/2021
Certification Date: 02/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 CONEY ISLAND AVE # 2060
BROOKLYN NY
11218-1843
US

IV. Provider business mailing address

348 CONEY ISLAND AVE # 2060
BROOKLYN NY
11218-1843
US

V. Phone/Fax

Practice location:
  • Phone: 914-294-4995
  • Fax:
Mailing address:
  • Phone: 914-294-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number088373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: