Provider Demographics
NPI:1497395636
Name:HICKEY, DALAISE (LMSW)
Entity Type:Individual
Prefix:
First Name:DALAISE
Middle Name:
Last Name:HICKEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SIERRA VISTA LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2724
Mailing Address - Country:US
Mailing Address - Phone:914-226-6356
Mailing Address - Fax:
Practice Address - Street 1:925 SIERRA VISTA LN
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2724
Practice Address - Country:US
Practice Address - Phone:914-226-6356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker