| Kim Clarissa Dallas, LMSW | |
|
239 Golden Hill Ln, Kingston, NY 12401-6441 | |
| (845) 340-4135 | |
| (845) 340-4094 |
| Full Name | Kim Clarissa Dallas |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 239 Golden Hill Ln, Kingston, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851383889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC06207700 (New Jersey) | Primary |
| 104100000X | Social Worker | 073220 (New York) | Secondary |
| Entity Name | Live Life Now Health Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770111429 PECOS PAC ID: 9537581897 Enrollment ID: O20200616000823 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221117000517 |
| Entity Name | Doctor On Demand Professionals P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174931448 PECOS PAC ID: 9436464567 Enrollment ID: O20231013002360 |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Clarissa Dallas, LMSW 239 Golden Hill Ln, Kingston, NY 12401-6441 Ph: (845) 340-4125 | Kim Clarissa Dallas, LMSW 239 Golden Hill Ln, Kingston, NY 12401-6441 Ph: (845) 340-4135 |
Mary Alice Scully, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 465 Broadway, Kingston, NY 12401 Phone: 845-340-0244 | |
Ms. Sharon M Koczaja, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 70 Kukuk Ln, Kingston, NY 12401 Phone: 845-336-2616 Fax: 845-336-3302 | |
Ms. Madeline Joy Rosensweet, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 261 Smith Ave, Kingston, NY 12401 Phone: 917-363-3675 | |
Ms. Sue Rosenberg, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 239 Golden Hill Ln, Kingston, NY 12401 Phone: 845-340-4141 | |
Ms. Margaret Martha Shlasko, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 239 Golden Hill Ln, Kingston, NY 12401 Phone: 845-340-4167 Fax: 845-340-4094 | |
Ms. Cheri Sciacca, LCSWR, CASAC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 239 Golden Hill Ln, Ulster County Mental Health Department, Kingston, NY 12401 Phone: 845-340-4123 | |
Jamal Davis Neal Jr., LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 168 Cornell St Ste 201, Kingston, NY 12401 Phone: 845-377-6511 |