Dussmann, Wanda
Dussmann, Wanda is an individual health care provider with primary practice located at 500 Montauk Hwy Suite M, West Islip NY 11795. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dussmann, Wanda can be contacted via phone (631) 661-1816.Contact Information
Primary practice address
500 Montauk Hwy Suite M
West Islip NY 11795
Phone: (631) 661-1816
Fax: (631) 661-5693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R013221 | New York |
Profile Details
| NPI number | 1629142831 |
|---|---|
| LBN Legal business name | Dussmann, Wanda |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629142831 | NPPES |
| New York | MEDICAID | 02027645 |
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