Provider Demographics
NPI:1124297171
Name:PLANTE, DOREEN L (LCSW)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:L
Last Name:PLANTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:L
Other - Last Name:ZUMPANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:64 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2044
Mailing Address - Country:US
Mailing Address - Phone:516-305-7922
Mailing Address - Fax:516-608-0383
Practice Address - Street 1:64 W PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2044
Practice Address - Country:US
Practice Address - Phone:516-305-7922
Practice Address - Fax:516-608-0383
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027383-11041C0700X
CT0035991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical