Doctor Name: | MARTIN DACUNHA |
NPI Number: | 1881939452 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 007900 |
Business Practice Address: | 38 Smith St Bldg 804 Niantic, CT - 06037 |
Business Phone Number: | 8607399672 |
Business Fax Number: | |
Mailing Address: | 11 Maple Ave, HOLBROOK |
State: | NY |
Postal Code: | 117411801 |
Phone Number: | 6315886304 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2012 |
NPI Last Update Date: | 12/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 007900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |