Deanna Rose Doherty, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111618 Issued in NY

Practice address

767 Broadway
#1327
New York, NY 10003

Phone

(781) 664-0647

NPI assigned

Oct 2, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shifting Tides Therapy LMSW, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Petersburg, FL
  • NPI 1114762788
  NPD Authorized official
• Tabitha Sieloff LCSW PLLC

  • Clinical Social Worker
  • Kingston, NY
  • NPI 1356841209
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1336780295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 BROADWAY",
            "address_2": "PO BOX #1327",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "781-664-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 BROADWAY",
            "address_2": "#1327",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "781-664-0647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Fairview Ave Suite 500",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "NY",
            "postal_code": "12534",
            "country_code": "US",
            "telephone_number": "845-768-2295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Lombard St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065132910",
            "country_code": "US",
            "telephone_number": "203-787-2207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 High Street",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "06460",
            "country_code": "US",
            "telephone_number": "203-874-6270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "DEANNA",
        "middle_name": "ROSE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "09788301",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "111618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Deron Dohanich, OD
• Dana O. Doheny, MS
• Alanna Doherty
• Alyssa Doherty, RN
• Colleen Larkin Doherty
• James J Doherty, LCSW-R
• Laura Gay Doherty, LMSW
• Liam Doherty
• Madison Shae Doherty, PT, DPT
• Tara Doherty

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.