Provider Demographics
NPI:1154481604
Name:JAMES, DONALD DALE (LCSW, CASAC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:DALE
Last Name:JAMES
Suffix:
Gender:M
Credentials:LCSW, CASAC
Other - Prefix:MR
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, CASAC
Mailing Address - Street 1:3 BROOK TRL
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-6617
Mailing Address - Country:US
Mailing Address - Phone:845-614-7169
Mailing Address - Fax:
Practice Address - Street 1:37 S BROADWAY
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3135
Practice Address - Country:US
Practice Address - Phone:914-980-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO42899-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical