Provider Demographics
NPI:1225000441
Name:DESILETS, DOLORES M (CASAC)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:M
Last Name:DESILETS
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E 85TH ST
Mailing Address - Street 2:#6F
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7421
Mailing Address - Country:US
Mailing Address - Phone:212-249-2197
Mailing Address - Fax:
Practice Address - Street 1:515 E 85TH ST
Practice Address - Street 2:#6F
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10028-7421
Practice Address - Country:US
Practice Address - Phone:212-249-2197
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)