Provider Demographics
NPI:1972791945
Name:MCMANUS, DINA BETH (LCSW-R)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:BETH
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4627
Mailing Address - Country:US
Mailing Address - Phone:518-698-4433
Mailing Address - Fax:518-242-4747
Practice Address - Street 1:391 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1491
Practice Address - Country:US
Practice Address - Phone:518-242-4731
Practice Address - Fax:518-242-4747
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0580651041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker