Provider Demographics
NPI:1952508905
Name:TUMA, DOROTHY A (CSW)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:A
Last Name:TUMA
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:A
Other - Last Name:VANDESTOUWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:21 S HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6141
Mailing Address - Country:US
Mailing Address - Phone:631-254-0047
Mailing Address - Fax:631-766-3262
Practice Address - Street 1:21 S HOLLOW RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6141
Practice Address - Country:US
Practice Address - Phone:631-254-0047
Practice Address - Fax:631-766-3262
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074209-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03515060Medicaid
NYNOG511Medicare ID - Type Unspecified