Provider Demographics
NPI:1619793411
Name:DANIEL, DEXTER CLAUDE (DSW, LMSW)
Entity type:Individual
Prefix:DR
First Name:DEXTER
Middle Name:CLAUDE
Last Name:DANIEL
Suffix:
Gender:M
Credentials:DSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 HEMPSTEAD TPKE # 1061
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2404
Mailing Address - Country:US
Mailing Address - Phone:631-486-0741
Mailing Address - Fax:
Practice Address - Street 1:927 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1924
Practice Address - Country:US
Practice Address - Phone:631-486-0741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11082901104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker