Healthcare Provider Details

I. General information

NPI: 1568371854
Provider Name (Legal Business Name): CHRISTOPHER BYARS DALEY LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHRIS DALEY LMSW

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 WELLING CT APT 2
ASTORIA NY
11102-4005
US

IV. Provider business mailing address

1159 WELLING CT APT 2
ASTORIA NY
11102-4005
US

V. Phone/Fax

Practice location:
  • Phone: 217-390-1322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132224-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: