Provider Demographics
NPI:1548846868
Name:CONCEPCION, YESENIA
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 W 112TH ST APT 2G71
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3920
Mailing Address - Country:US
Mailing Address - Phone:347-579-8672
Mailing Address - Fax:
Practice Address - Street 1:9413 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3726
Practice Address - Country:US
Practice Address - Phone:718-272-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health