Healthcare Provider Details

I. General information

NPI: 1104230721
Provider Name (Legal Business Name): DACIA MCBEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 FRANKLIN ST
SCHENECTADY NY
12305-2011
US

IV. Provider business mailing address

3 OKARA DR APT 5
SCHENECTADY NY
12303-5743
US

V. Phone/Fax

Practice location:
  • Phone: 518-381-8911
  • Fax:
Mailing address:
  • Phone: 607-592-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: