Basic Information
Provider Information
NPI: 1811281405
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANSOWAAH
FirstName: NANA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2510 WESTCHESTER AVE
Address2:  
City: BRONX
State: NY
PostalCode: 104613512
CountryCode: US
TelephoneNumber: 7185975558
FaxNumber:  
Practice Location
Address1: 2510 WESTCHESTER AVE
Address2:  
City: BRONX
State: NY
PostalCode: 104613512
CountryCode: US
TelephoneNumber: 7185975558
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/01/2011
LastUpdateDate: 09/17/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X083570-1NYY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home