Provider Demographics
NPI:1164713962
Name:DADARRIA, ELAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:
Last Name:DADARRIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:DADARRIA-PASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:21 TOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1030
Mailing Address - Country:US
Mailing Address - Phone:631-744-5933
Mailing Address - Fax:631-744-0900
Practice Address - Street 1:27 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1342
Practice Address - Country:US
Practice Address - Phone:631-744-5933
Practice Address - Fax:631-744-0900
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical