Provider Demographics
NPI:1154049666
Name:BARICEVIC, YOLANDA (SW)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:BARICEVIC
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 90TH ST APT A52
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-9222
Mailing Address - Country:US
Mailing Address - Phone:917-832-0094
Mailing Address - Fax:
Practice Address - Street 1:860 MELROSE AVE FRNT 2L
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5757
Practice Address - Country:US
Practice Address - Phone:917-476-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115409104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty