Provider Demographics
NPI:1205217585
Name:DOBRIS, NINA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:S
Last Name:DOBRIS
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 1:6725 DARTMOUTH ST
Mailing Address - Street 2:APT. 4H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4058
Mailing Address - Country:US
Mailing Address - Phone:917-604-8177
Mailing Address - Fax:
Practice Address - Street 1:6725 DARTMOUTH ST
Practice Address - Street 2:APT. 4H
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4058
Practice Address - Country:US
Practice Address - Phone:917-604-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073167-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical