Provider Demographics
NPI:1255827051
Name:DADD, ALYCIA CARRANO (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALYCIA
Middle Name:CARRANO
Last Name:DADD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:ALYCIA
Other - Middle Name:LIZABETH
Other - Last Name:CARRANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 FLAT ROCK DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5311
Mailing Address - Country:US
Mailing Address - Phone:917-216-2004
Mailing Address - Fax:
Practice Address - Street 1:1 N BROADWAY STE 704
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2320
Practice Address - Country:US
Practice Address - Phone:914-385-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022705103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist