Provider Demographics
NPI:1477186187
Name:NOVOA, DHESYRE (LCSW)
Entity Type:Individual
Prefix:
First Name:DHESYRE
Middle Name:
Last Name:NOVOA
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:PO BOX 1586
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07509-1586
Mailing Address - Country:US
Mailing Address - Phone:973-348-5594
Mailing Address - Fax:
Practice Address - Street 1:90 3RD AVE # 2
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2414
Practice Address - Country:US
Practice Address - Phone:973-348-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical