Provider Demographics
NPI:1255096509
Name:INNERFELD, DARA (LMFT)
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:INNERFELD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 29TH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2721
Mailing Address - Country:US
Mailing Address - Phone:646-389-5725
Mailing Address - Fax:
Practice Address - Street 1:3806 29TH ST APT 8
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2721
Practice Address - Country:US
Practice Address - Phone:646-389-5725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001696106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist