Healthcare Provider Details

I. General information

NPI: 1154093045
Provider Name (Legal Business Name): DENAE STALLINGS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6214 RIVERDALE AVE # 1A
BRONX NY
10471-1032
US

IV. Provider business mailing address

301 E 92ND ST APT 2B
NEW YORK NY
10128-5945
US

V. Phone/Fax

Practice location:
  • Phone: 718-701-4807
  • Fax:
Mailing address:
  • Phone: 347-922-3081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100822-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: