Provider Demographics
NPI:1366794240
Name:KOTT, YEHUDIS DEDE (LCSW)
Entity type:Individual
Prefix:
First Name:YEHUDIS
Middle Name:DEDE
Last Name:KOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YEHUDIS
Other - Middle Name:DEDE
Other - Last Name:SCHWARZMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 MAPLE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2240
Mailing Address - Country:US
Mailing Address - Phone:516-522-0257
Mailing Address - Fax:
Practice Address - Street 1:123 MAPLE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2240
Practice Address - Country:US
Practice Address - Phone:516-522-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
NY090800-1106H00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist