Healthcare Provider Details

I. General information

NPI: 1962150086
Provider Name (Legal Business Name): MISHA VERNATTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WHITE PLAINS RD
EASTCHESTER NY
10709-2826
US

IV. Provider business mailing address

375 WHITE PLAINS RD
EASTCHESTER NY
10709-2826
US

V. Phone/Fax

Practice location:
  • Phone: 914-337-5300
  • Fax:
Mailing address:
  • Phone: 914-337-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092209
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: