Provider Demographics
NPI:1619263779
Name:SPIRA, DUVID (LCSW)
Entity Type:Individual
Prefix:
First Name:DUVID
Middle Name:
Last Name:SPIRA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 16TH AVE # 184
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1425
Mailing Address - Country:US
Mailing Address - Phone:718-501-2308
Mailing Address - Fax:347-435-0904
Practice Address - Street 1:5302 15TH AVE APT 1G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4331
Practice Address - Country:US
Practice Address - Phone:718-501-2308
Practice Address - Fax:347-435-0904
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0786741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical