Provider Demographics
NPI:1972894830
Name:JASPHY, LAURA G (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:G
Last Name:JASPHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W 78TH ST
Mailing Address - Street 2:APT. 4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6625
Mailing Address - Country:US
Mailing Address - Phone:917-576-0141
Mailing Address - Fax:
Practice Address - Street 1:226 W 78TH ST
Practice Address - Street 2:APT. 4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6625
Practice Address - Country:US
Practice Address - Phone:917-576-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0512421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP73246Medicare UPIN