Provider Demographics
NPI:1689255002
Name:DAVY, DIAMANTIE (LMSW)
Entity Type:Individual
Prefix:
First Name:DIAMANTIE
Middle Name:
Last Name:DAVY
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 1:197 DRAKE AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1768
Mailing Address - Country:US
Mailing Address - Phone:646-201-7190
Mailing Address - Fax:
Practice Address - Street 1:197 DRAKE AVE APT 1J
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-1768
Practice Address - Country:US
Practice Address - Phone:646-201-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112411104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty