Provider Demographics
NPI:1639392145
Name:SUSAN M. D'ADDARIO, LCSW
Entity Type:Organization
Organization Name:SUSAN M. D'ADDARIO, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:D'ADDARIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-974-0935
Mailing Address - Street 1:140 W 71ST ST
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4018
Mailing Address - Country:US
Mailing Address - Phone:212-974-0935
Mailing Address - Fax:
Practice Address - Street 1:140 W 71ST ST
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4018
Practice Address - Country:US
Practice Address - Phone:212-974-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053437-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty