Provider Demographics
NPI:1841431483
Name:DUNLAP, MOYA DARNELL (LMSW)
Entity Type:Individual
Prefix:
First Name:MOYA
Middle Name:DARNELL
Last Name:DUNLAP
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 1:1336 ODELL ST.
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462
Mailing Address - Country:US
Mailing Address - Phone:718-285-0553
Mailing Address - Fax:
Practice Address - Street 1:274 W 145TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-4122
Practice Address - Country:US
Practice Address - Phone:212-368-4100
Practice Address - Fax:212-282-5041
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72P68973104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker