Provider Demographics
NPI:1043444045
Name:MORALES, JOHNOLA THIRZA (LMSW)
Entity type:Individual
Prefix:
First Name:JOHNOLA
Middle Name:THIRZA
Last Name:MORALES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JOHNOLA
Other - Middle Name:THIRZA
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:7 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4009
Mailing Address - Country:US
Mailing Address - Phone:516-825-2418
Mailing Address - Fax:
Practice Address - Street 1:7 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4009
Practice Address - Country:US
Practice Address - Phone:516-825-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047751-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker