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Contact Information

THERESA M DYER, LCSW-R
177 WOODHULL AVE
RIVERHEAD, NY11901-3513
 Phone: 631-553-5212
 Fax: 631-939-2096
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

School

1041S0200X
Indicates primary specialty

NPI Profile & details for THERESA M DYER · (Female)

NPI Number 1366650467
Status Active
Credentials LCSW-R
Entity Individual
Enumeration date 05/21/2007
Last updated 10/12/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • NY License # R045529-1
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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