Provider Demographics
NPI:1700961216
Name:GRECO, DANA MARIE (LMSW)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:MARIE
Last Name:GRECO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:GRECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:536 WEST 111TH STREET
Mailing Address - Street 2:#5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-663-5856
Mailing Address - Fax:
Practice Address - Street 1:536 WEST 111TH STREET
Practice Address - Street 2:#5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-663-5856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076703-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker