Provider Demographics
NPI:1174098222
Name:BREGAUDIT, ALVEEN ASHBEE (LMSW)
Entity type:Individual
Prefix:
First Name:ALVEEN
Middle Name:ASHBEE
Last Name:BREGAUDIT
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 W 148TH ST APT 51
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-4137
Mailing Address - Country:US
Mailing Address - Phone:315-491-6862
Mailing Address - Fax:
Practice Address - Street 1:484 ROCKAWAY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5636
Practice Address - Country:US
Practice Address - Phone:718-495-6700
Practice Address - Fax:718-485-4018
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103401104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker