Healthcare Provider Details

I. General information

NPI: 1477479012
Provider Name (Legal Business Name): STEPHANIE ADAEZE OPARA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 CENTRAL PARK AVE
YONKERS NY
10704-1044
US

IV. Provider business mailing address

1250 CENTRAL PARK AVE
YONKERS NY
10704-1044
US

V. Phone/Fax

Practice location:
  • Phone: 914-614-9967
  • Fax: 718-540-8840
Mailing address:
  • Phone: 914-614-9967
  • Fax: 718-540-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130067-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: