Provider Demographics
NPI:1730237306
Name:ARDAO, DAVID (LCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ARDAO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W 48TH ST
Mailing Address - Street 2:SUITE 34E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1404
Mailing Address - Country:US
Mailing Address - Phone:212-541-9540
Mailing Address - Fax:
Practice Address - Street 1:235 W 48TH ST
Practice Address - Street 2:SUITE 34E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1404
Practice Address - Country:US
Practice Address - Phone:212-541-9540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049186-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health