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NPI Code Detail

MEDICARE: DINA BETH MCMANUS LCSW-R

MEDICARE: DINA BETH MCMANUS LCSW-R
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerR058065NY
21041C0700XClinical Social WorkerC017297NC
31041C0700XClinical Social WorkerR058065NY

General Provider Information

NPI Number : 1972791945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA BETH MCMANUS LCSW-R
Provider Business Mailing Address
First Line : 251 NEW KARNER RD
Second Line :
City : ALBANY
State : NY
Zip : 12205-4627
Country : US
Telephone Number : 518-698-4433
Fax Number : 518-242-4747
Provider Business Practice Location Address
First Line : 391 WESTERN AVE
Second Line :
City : ALBANY
State : NY
Zip : 12203-1491
Country : US
Telephone Number : 518-242-4731
Fax Number : 518-242-4747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2007
Last Update Date : 07/19/2024

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