Provider Demographics
NPI:1689882797
Name:DUMAIS, DAVID J (LCSW, CGP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:DUMAIS
Suffix:
Gender:M
Credentials:LCSW, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5911
Mailing Address - Country:US
Mailing Address - Phone:718-832-6247
Mailing Address - Fax:718-283-8272
Practice Address - Street 1:474 16TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5911
Practice Address - Country:US
Practice Address - Phone:917-838-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR 0459491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical