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General NPI Number Information
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NPI Number | 1841560166
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Entity Type | Individual
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Provider Name | JONATHAN JOSEPH VERHEY LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 1346 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3906
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Country | US
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Telephone | 917-968-1445
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Fax |
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Provider Business Mailing Address
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Address Line | 27 E RALEIGH AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-2811
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Country | US
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Telephone | 917-968-1445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 071375
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License Number State | NY
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