Provider Demographics
NPI:1730196858
Name:JAVORS, IRENE
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:JAVORS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:IRENE
Other - Middle Name:ROSENBERG
Other - Last Name:JAVORS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:96 5TH AVE
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7605
Mailing Address - Country:US
Mailing Address - Phone:917-584-3527
Mailing Address - Fax:
Practice Address - Street 1:96 5TH AVE
Practice Address - Street 2:SUITE 1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7605
Practice Address - Country:US
Practice Address - Phone:917-584-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000362-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health