Provider Demographics
NPI:1124041231
Name:WINTER, M. DENISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:M. DENISE
Middle Name:
Last Name:WINTER
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 1:175 N CENTRAL AVE
Mailing Address - Street 2:VALLEY STREAM 30 UFSD
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3801
Mailing Address - Country:US
Mailing Address - Phone:516-792-5152
Mailing Address - Fax:
Practice Address - Street 1:175 N CENTRAL AVE
Practice Address - Street 2:VALLEY STREAM 30 UFSD
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3801
Practice Address - Country:US
Practice Address - Phone:516-792-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069608104100000X
NY0776881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker