Provider Demographics
NPI:1346540838
Name:DIMUN, AMY (LMHC, CASAC, CRC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DIMUN
Suffix:
Gender:F
Credentials:LMHC, CASAC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 DURAND RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2106
Mailing Address - Country:US
Mailing Address - Phone:973-477-9034
Mailing Address - Fax:
Practice Address - Street 1:340 E 24TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4019
Practice Address - Country:US
Practice Address - Phone:212-585-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-30
Last Update Date:2010-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000859-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health