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General NPI Number Information
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NPI Number | 1447819081
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Entity Type | Organization
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Legal Business Name | BETTINA YANEZ LCSW PLLC
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 25 MEVILLE PARK RD SUITE 223
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City | MELVILLE
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State | NY
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Zip | 11747-1174
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Country | US
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Telephone | 516-351-1912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 944
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City | FARMINGDALE
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State | NY
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Zip | 11735-0852
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Country | US
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Telephone | 516-351-1912
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. BETTINA YANEZ
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Credential | LCSW
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Telephone | 516-351-1912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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