Provider Demographics
NPI:1083769640
Name:SEBBAG, DANIEL A (LCSW, PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:SEBBAG
Suffix:
Gender:M
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 NETHERLAND AVE APT 325
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4855
Mailing Address - Country:US
Mailing Address - Phone:917-957-5268
Mailing Address - Fax:
Practice Address - Street 1:159 W 53RD ST APT 33H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6068
Practice Address - Country:US
Practice Address - Phone:917-957-5268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker