Healthcare Provider Details

I. General information

NPI: 1922389626
Provider Name (Legal Business Name): NONNA VINOKUR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 AVENUE T
BROOKLYN NY
11234-4911
US

IV. Provider business mailing address

3320 AVENUE T
BROOKLYN NY
11234-4911
US

V. Phone/Fax

Practice location:
  • Phone: 347-554-1518
  • Fax: 718-382-3358
Mailing address:
  • Phone: 347-554-1518
  • Fax: 718-535-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number082221-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20185
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: