Provider Demographics
NPI:1770716854
Name:UZDAWINIS, DOROTA (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:DOROTA
Middle Name:
Last Name:UZDAWINIS
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 ADELPHI ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3301
Mailing Address - Country:US
Mailing Address - Phone:917-771-3314
Mailing Address - Fax:
Practice Address - Street 1:211 GREENE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1221
Practice Address - Country:US
Practice Address - Phone:917-771-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004220101YM0800X
NY021252103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health