Provider Demographics
NPI:1770119737
Name:DOBKIN, INNA (LCSW)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:DOBKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BLOSSOM TER
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3301
Mailing Address - Country:US
Mailing Address - Phone:917-602-0358
Mailing Address - Fax:
Practice Address - Street 1:29 BLOSSOM TER
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3301
Practice Address - Country:US
Practice Address - Phone:917-414-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health