Provider Demographics
NPI:1417747734
Name:SASS-DIAZ, ABIGAIL (LCSW-R)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SASS-DIAZ
Suffix:
Gender:
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 HAMPTON GRN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1742
Mailing Address - Country:US
Mailing Address - Phone:718-490-3287
Mailing Address - Fax:
Practice Address - Street 1:120 STUYVESANT PL STE 410
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1992
Practice Address - Country:US
Practice Address - Phone:718-727-9722
Practice Address - Fax:718-448-0605
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0558071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical