Provider Demographics
NPI:1962710269
Name:BALSAM-RESPLER, YAEL ELLA (PHD)
Entity type:Individual
Prefix:DR
First Name:YAEL
Middle Name:ELLA
Last Name:BALSAM-RESPLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:YAEL
Other - Middle Name:
Other - Last Name:RESPLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1762 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1933
Mailing Address - Country:US
Mailing Address - Phone:718-259-4965
Mailing Address - Fax:718-259-8403
Practice Address - Street 1:1762 55TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1933
Practice Address - Country:US
Practice Address - Phone:718-259-4965
Practice Address - Fax:718-259-8403
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO203951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical