Provider Demographics
NPI:1346648920
Name:HUBBARD, DOROTHY JEAN
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:JEAN
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:JEAN
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:303 WEST 66 STREET
Mailing Address - Street 2:#5AW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6470
Mailing Address - Country:US
Mailing Address - Phone:212-627-8181
Mailing Address - Fax:
Practice Address - Street 1:115 WEST 27 STREET 4TH FLOOR
Practice Address - Street 2:TRAINING INSTITUTE FOR MENTAL HEALTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6217
Practice Address - Country:US
Practice Address - Phone:212-627-8181
Practice Address - Fax:646-638-3025
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0646431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical