Provider Demographics
NPI:1437699311
Name:CHAMBERS, DANA (LMHC, MS ED)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LMHC, MS ED
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:ROSTERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, MS ED
Mailing Address - Street 1:1737 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1529
Mailing Address - Country:US
Mailing Address - Phone:631-479-2900
Mailing Address - Fax:631-417-3048
Practice Address - Street 1:1737 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1529
Practice Address - Country:US
Practice Address - Phone:631-479-2900
Practice Address - Fax:631-417-3048
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18 007213101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health