Provider Demographics
NPI:1588339824
Name:DESHPANDE, JAY ALEXANDER (LMSW)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:ALEXANDER
Last Name:DESHPANDE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:347-630-0519
Practice Address - Street 1:705 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2909
Practice Address - Country:US
Practice Address - Phone:857-314-0489
Practice Address - Fax:347-630-0519
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116489104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker