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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629142831 NPPES
New York MEDICAID 02027645

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