Provider Demographics
NPI:1518789775
Name:VASSELL, TERRY A (CMHC-LP)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:A
Last Name:VASSELL
Suffix:
Gender:M
Credentials:CMHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2488 GRAND CONCOURSE
Mailing Address - Street 2:2ND FLOOR, SUITE 2000
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2488 GRAND CONCOURSE
Practice Address - Street 2:2ND FLOOR, SUITE 2000
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:917-392-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker