Provider Demographics
NPI:1326224247
Name:GERMOSEN, DOREEN AMALFY (LCSW)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:AMALFY
Last Name:GERMOSEN
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 1:839 14TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-3132
Mailing Address - Country:US
Mailing Address - Phone:718-413-9897
Mailing Address - Fax:
Practice Address - Street 1:839 14TH ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-3132
Practice Address - Country:US
Practice Address - Phone:718-413-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker