Provider Demographics
NPI:1275067373
Name:PATEL, DEENA GIRISH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:GIRISH
Last Name:PATEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DEENA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:61 MARTENSE ST APT 6J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3263
Mailing Address - Country:US
Mailing Address - Phone:706-372-2428
Mailing Address - Fax:
Practice Address - Street 1:50 W 112TH ST
Practice Address - Street 2:APT 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3903
Practice Address - Country:US
Practice Address - Phone:706-372-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091971-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker