Provider Demographics
NPI:1629443098
Name:TIBURCIO, DHESIAY SILVIA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:DHESIAY
Middle Name:SILVIA
Last Name:TIBURCIO
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 1:1268 CLAY AVE
Mailing Address - Street 2:APT 3A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3339
Mailing Address - Country:US
Mailing Address - Phone:347-360-9185
Mailing Address - Fax:
Practice Address - Street 1:1268 CLAY AVE
Practice Address - Street 2:APT 3A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3339
Practice Address - Country:US
Practice Address - Phone:347-360-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096410-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker