Healthcare Provider Details

I. General information

NPI: 1093388829
Provider Name (Legal Business Name): DANIELLE BROFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 HAIGHT AVE STE 203
POUGHKEEPSIE NY
12603-7205
US

IV. Provider business mailing address

510 HAIGHT AVE
POUGHKEEPSIE NY
12603-7204
US

V. Phone/Fax

Practice location:
  • Phone: 518-245-6272
  • Fax:
Mailing address:
  • Phone: 518-245-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number114569
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103247
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: