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General NPI Number Information
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NPI Number | 1588386890
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Entity Type | Organization
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Legal Business Name | DEAR DIARY PSYCHOTHERAPY LCSW SERVICES PLLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 204 MACDOUGAL ST
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City | BROOKLYN
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State | NY
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Zip | 11233-2707
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Country | US
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Telephone | 917-749-2189
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MACDOUGAL ST
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City | BROOKLYN
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State | NY
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Zip | 11233-2707
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Country | US
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Telephone | 917-749-2189
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. DEIRDRE WILLIAMS
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Credential | DSW, LCSW
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Telephone | 201-455-7174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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