Provider Demographics
NPI:1053051151
Name:KULLER, DANA (LCSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KULLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2603
Mailing Address - Country:US
Mailing Address - Phone:929-274-1816
Mailing Address - Fax:
Practice Address - Street 1:10 ESTATES DR
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-2603
Practice Address - Country:US
Practice Address - Phone:929-274-1816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical