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Individual
KHADIJAH G PEGUERO
Active
Individual
KHADIJAH G PEGUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111633
NY
1041C0700X
Clinical Social Worker
Primary
103471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111633
LMSW LICENSE
NY
Enumeration date
10/12/2022
Last updated
07/28/2026
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