Provider Demographics
NPI:1235947151
Name:ORTEGA ALEXANDER, YOLANDA (LMSW)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:ORTEGA ALEXANDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-1313
Mailing Address - Country:US
Mailing Address - Phone:914-224-7304
Mailing Address - Fax:
Practice Address - Street 1:302 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1313
Practice Address - Country:US
Practice Address - Phone:914-224-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050624104100000X
104100000X
NY7114251041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker