Healthcare Provider Details

I. General information

NPI: 1497894737
Provider Name (Legal Business Name): CYNTHIA LEE DAILY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 OLD COUNTRY RD BLDG H
PLAINVIEW NY
11803-5010
US

IV. Provider business mailing address

74 PARK AVE
GARDEN CITY PARK NY
11040-5150
US

V. Phone/Fax

Practice location:
  • Phone: 516-573-5053
  • Fax:
Mailing address:
  • Phone: 516-746-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number074765
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: