Provider Demographics
NPI:1124720834
Name:JOAQUIM, VIRGINIA (LCSW-R)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:JOAQUIM
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2427
Mailing Address - Country:US
Mailing Address - Phone:914-761-0600
Mailing Address - Fax:914-761-5367
Practice Address - Street 1:141 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1912
Practice Address - Country:US
Practice Address - Phone:914-949-7699
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053358-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical