Provider Demographics
NPI:1164232815
Name:D'ORIA, NATHAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:
Last Name:D'ORIA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3412
Mailing Address - Country:US
Mailing Address - Phone:631-327-2487
Mailing Address - Fax:
Practice Address - Street 1:2171 JERICHO TPKE STE 240
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2900
Practice Address - Country:US
Practice Address - Phone:163-148-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123612104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker