Provider Demographics
NPI:1710040779
Name:PRICE, DAVID DELROY (LCSWR)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DELROY
Last Name:PRICE
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 141ST ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1615
Mailing Address - Country:US
Mailing Address - Phone:171-884-9797
Mailing Address - Fax:
Practice Address - Street 1:11021 73RD RD APT 1J SUITE 3
Practice Address - Street 2:QUEENS
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6369
Practice Address - Country:US
Practice Address - Phone:171-841-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR061140-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical