Provider Demographics
NPI:1275599383
Name:DALY, JOAN D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:D
Last Name:DALY
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 1:96 SCHERMERHORN ST
Mailing Address - Street 2:1F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5035
Mailing Address - Country:US
Mailing Address - Phone:718-596-1690
Mailing Address - Fax:
Practice Address - Street 1:96 SCHERMERHORN ST
Practice Address - Street 2:1F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5039
Practice Address - Country:US
Practice Address - Phone:347-886-1630
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0044131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN36D81Medicare ID - Type Unspecified