Provider Demographics
NPI:1710579289
Name:DUKACH, INNA (MHC-LP)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:DUKACH
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-1101
Mailing Address - Country:US
Mailing Address - Phone:917-693-4909
Mailing Address - Fax:
Practice Address - Street 1:464 W 153RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1101
Practice Address - Country:US
Practice Address - Phone:917-693-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health