Provider Demographics
NPI:1114411121
Name:DESIENA, WILLIAM (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:DESIENA
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 1:719 W NYACK RD STE 43
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2241
Mailing Address - Country:US
Mailing Address - Phone:917-681-4270
Mailing Address - Fax:
Practice Address - Street 1:719 W NYACK RD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2240
Practice Address - Country:US
Practice Address - Phone:917-681-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0918331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical