Provider Demographics
NPI:1184871527
Name:THOMAS, DANIEL VINCENT (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:VINCENT
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSW
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 BURRS LN
Mailing Address - Street 2:BRIDGES TO HEALTH PROGRAM
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6052
Mailing Address - Country:US
Mailing Address - Phone:631-213-0232
Mailing Address - Fax:631-253-3509
Practice Address - Street 1:151 BURRS LN
Practice Address - Street 2:BRIDGES TO HEALTH PROGRAM
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6052
Practice Address - Country:US
Practice Address - Phone:631-213-0232
Practice Address - Fax:631-253-3509
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088790104100000X
NY0845321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker