Healthcare Provider Details

I. General information

NPI: 1629995402
Provider Name (Legal Business Name): NYC SUPPORTIVE PSYCHOTHERAPY LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

896 MANHATTAN AVE STE 24
BROOKLYN NY
11222-2384
US

IV. Provider business mailing address

896 MANHATTAN AVE STE 24
BROOKLYN NY
11222-2384
US

V. Phone/Fax

Practice location:
  • Phone: 347-466-9449
  • Fax:
Mailing address:
  • Phone: 347-466-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA DADDI
Title or Position: MEMBER-MANAGER
Credential: LCSW
Phone: 347-466-9449