Provider Demographics
NPI:1326109398
Name:DUMAS, JUAN CARLOS (LMHC)
Entity Type:Individual
Prefix:PROF
First Name:JUAN
Middle Name:CARLOS
Last Name:DUMAS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 OAK NECK RD
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3613
Mailing Address - Country:US
Mailing Address - Phone:631-587-7218
Mailing Address - Fax:631-893-3109
Practice Address - Street 1:37-57 76TH STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372
Practice Address - Country:US
Practice Address - Phone:718-335-6611
Practice Address - Fax:631-893-3109
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000918101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health