Provider Demographics
NPI:1316684343
Name:KARASTANOVIC, EMILIJA (LMSW)
Entity type:Individual
Prefix:
First Name:EMILIJA
Middle Name:
Last Name:KARASTANOVIC
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:EMILIJA
Other - Middle Name:
Other - Last Name:KARASTANOVIC-HOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5 AMBROSE PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-6303
Mailing Address - Country:US
Mailing Address - Phone:917-403-4731
Mailing Address - Fax:
Practice Address - Street 1:753 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4951
Practice Address - Country:US
Practice Address - Phone:917-403-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116071-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker