Provider Demographics
NPI:1992087167
Name:KRASNOW, YEMANJA VIDAL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YEMANJA
Middle Name:VIDAL
Last Name:KRASNOW
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2778 REEVES RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4911
Mailing Address - Country:US
Mailing Address - Phone:786-266-3816
Mailing Address - Fax:
Practice Address - Street 1:296 LAKEPARK TRL
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8286
Practice Address - Country:US
Practice Address - Phone:407-669-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL142331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical