Provider Demographics
NPI:1336124460
Name:DAURIA, DENNIS PETER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:PETER
Last Name:DAURIA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DANVILLE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838
Mailing Address - Country:US
Mailing Address - Phone:908-637-8079
Mailing Address - Fax:908-674-8080
Practice Address - Street 1:1001 ROUTE 517
Practice Address - Street 2:SUITE ONE
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-797-3392
Practice Address - Fax:908-684-8080
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046459001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ266991000OtherMAGELLAN
NJ2151830000OtherAMERIHEALTH
NJ008349CXPMedicare ID - Type Unspecified
DA008349Medicare ID - Type Unspecified