Provider Demographics
NPI:1356726269
Name:PRADO-LEU, TIFFANY ERICA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ERICA
Last Name:PRADO-LEU
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 1:1767 CENTRAL PARK AVE # 303
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERDALE AVE
Practice Address - Street 2:APT. 11G
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4638
Practice Address - Country:US
Practice Address - Phone:773-678-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0935561041C0700X
NJ44SL060340001041C0700X
NY0874941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical