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Individual

MS. ASHLEY JOSARA DE VERTEUIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3300 NORTHERN BLVD FL 5, LONG ISLAND CITY, NY 11101-2215
(646) 265-6237
Mailing address
3300 NORTHERN BLVD FL 5, LONG ISLAND CITY, NY 11101-2215

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
087991
NY
1041C0700X
Clinical Social Worker
Primary
091108
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AP0814
NY
Enumeration date
03/19/2009
Last updated
07/23/2021
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