Provider Demographics
NPI:1427467232
Name:DENIS, DAPHNE
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:DENIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DAPHNE
Other - Middle Name:
Other - Last Name:DENIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:142 04 BAYSIDE AVENUE
Mailing Address - Street 2:10UB
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:516-673-5512
Mailing Address - Fax:
Practice Address - Street 1:142 04 BAYSIDE AVENUE
Practice Address - Street 2:10UB
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:516-673-5512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health