Provider Demographics
NPI:1730537564
Name:HOLLINGTON, YVETTE DIS'REE (MHC-LP)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:DIS'REE
Last Name:HOLLINGTON
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3627
Mailing Address - Country:US
Mailing Address - Phone:347-870-5454
Mailing Address - Fax:
Practice Address - Street 1:435 E 119TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3627
Practice Address - Country:US
Practice Address - Phone:212-360-4002
Practice Address - Fax:212-360-4011
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP01432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health