Provider Demographics
NPI:1740485960
Name:MOGEL, DEENA (LMSW)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:MOGEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-4500
Mailing Address - Country:US
Mailing Address - Phone:845-794-3249
Mailing Address - Fax:
Practice Address - Street 1:4504 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:SWAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:12783
Practice Address - Country:US
Practice Address - Phone:845-292-6880
Practice Address - Fax:845-292-4873
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065806104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker