Provider Demographics
NPI:1134752520
Name:HUTNICK, DANIEL (LMSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HUTNICK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:298 S AMENIA RD
Mailing Address - Street 2:
Mailing Address - City:AMENIA
Mailing Address - State:NY
Mailing Address - Zip Code:12501-5857
Mailing Address - Country:US
Mailing Address - Phone:347-421-1272
Mailing Address - Fax:
Practice Address - Street 1:350 GRAND ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4629
Practice Address - Country:US
Practice Address - Phone:212-475-4148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0894911041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool