Provider Demographics
NPI:1891008918
Name:DOBRICH, JOHANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:
Last Name:DOBRICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W 35TH ST
Mailing Address - Street 2:7TH FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1904
Mailing Address - Country:US
Mailing Address - Phone:631-456-2236
Mailing Address - Fax:
Practice Address - Street 1:225 W 35TH ST
Practice Address - Street 2:7TH FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1904
Practice Address - Country:US
Practice Address - Phone:631-456-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-18
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081493-1104100000X
NY081481-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker