Provider Demographics
NPI:1881416519
Name:AUTHERS, DYHEMA (LMSW)
Entity type:Individual
Prefix:
First Name:DYHEMA
Middle Name:
Last Name:AUTHERS
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 1:3360 BRUNER AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2726
Mailing Address - Country:US
Mailing Address - Phone:914-316-4436
Mailing Address - Fax:
Practice Address - Street 1:2932 WILKINSON AVE FL 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4004
Practice Address - Country:US
Practice Address - Phone:347-621-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07178600104100000X
NY124697-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker