Provider Demographics
NPI:1518593029
Name:DUMA, GLADYS LUCIA (LCSW)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:LUCIA
Last Name:DUMA
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 1:4135 67TH ST STE MD1
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3718
Mailing Address - Country:US
Mailing Address - Phone:646-427-8464
Mailing Address - Fax:718-424-6199
Practice Address - Street 1:9018 107TH AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1335
Practice Address - Country:US
Practice Address - Phone:646-427-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088822-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical