Provider Demographics
NPI:1053663120
Name:DATT, RIMJHIM (LMSW)
Entity Type:Individual
Prefix:
First Name:RIMJHIM
Middle Name:
Last Name:DATT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 67TH AVE
Mailing Address - Street 2:APT. 6E
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4967
Mailing Address - Country:US
Mailing Address - Phone:812-369-9690
Mailing Address - Fax:
Practice Address - Street 1:7409 37TH AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6300
Practice Address - Country:US
Practice Address - Phone:718-779-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72-087116104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker