Wanda Dussmann, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R013221 Issued in NY

Practice address

500 Montauk Hwy
Suite M
West Islip, NY 11795

Phone

(631) 661-1816

Fax

(631) 661-5693

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629142831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 OAK BEACH ASSN",
            "city": "OAK BEACH",
            "state": "NY",
            "postal_code": "117024619",
            "telephone_number": "631-669-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MONTAUK HWY",
            "address_2": "SUITE M",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "11795",
            "telephone_number": "631-661-1816",
            "fax_number": "631-661-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSMANN",
        "first_name": "WANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R013221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02027645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Duane, DMD
• Diana Paola Duarte, PA
• Aleksandr Dubrovskiy, D.O.
• Keith Raymond Durante, MD
• Tara Duras
• Ronald Dvorkin, MD
• Michele Dykstra, PT
• E a Duane and B R McCurdy Partners
• East Coast Fertility, P.C.
• Rebecca Eastman, MD

• Clinical Social Worker in West Islip, NY
• Providers in West Islip, 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 8, 2007; 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.