Provider Demographics
NPI:1609339977
Name:YEDID, JOY (LCSW)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:YEDID
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 OCEAN PKWY APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3404
Mailing Address - Country:US
Mailing Address - Phone:917-832-4612
Mailing Address - Fax:
Practice Address - Street 1:965 OCEAN PKWY APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3404
Practice Address - Country:US
Practice Address - Phone:917-832-4612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2024-07-19
Deactivation Date:2019-06-28
Deactivation Code:
Reactivation Date:2020-04-08
Provider Licenses
StateLicense IDTaxonomies
NY0979971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty