Provider Demographics
NPI:1174236129
Name:GONZALEZ, YOLANDA (LMSW)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:377 N BROADWAY APT 706
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-2052
Mailing Address - Country:US
Mailing Address - Phone:914-318-6366
Mailing Address - Fax:
Practice Address - Street 1:377 N BROADWAY APT 706
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2052
Practice Address - Country:US
Practice Address - Phone:914-318-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker