Provider Demographics
NPI:1093095879
Name:LESSANS, STACEY DANKNER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:DANKNER
Last Name:LESSANS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:STACEY
Other - Middle Name:ERIN
Other - Last Name:DANKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1965 BROADWAY
Mailing Address - Street 2:APARTMENT 15 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5928
Mailing Address - Country:US
Mailing Address - Phone:516-996-3310
Mailing Address - Fax:
Practice Address - Street 1:141 E 55TH ST
Practice Address - Street 2:3D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4030
Practice Address - Country:US
Practice Address - Phone:516-996-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019240103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical