Provider Demographics
NPI:1528477593
Name:HIGHSMITH, DASHA (SSP, NCSP)
Entity type:Individual
Prefix:
First Name:DASHA
Middle Name:
Last Name:HIGHSMITH
Suffix:
Gender:F
Credentials:SSP, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CLINTON C BOONE PL
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5534
Mailing Address - Country:US
Mailing Address - Phone:516-538-5148
Mailing Address - Fax:
Practice Address - Street 1:4 CLINTON C BOONE PL
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5534
Practice Address - Country:US
Practice Address - Phone:516-538-5148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool