Individual
DEVENA S SOUTHWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
233 LAFAYETTE ST, NEW YORK, NY 10012-4051
(212) 431-6177
Mailing address
233 LAFAYETTE ST, NEW YORK, NY 10012-4051
(212) 431-6177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38411
NY
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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