Individual
MR. DENNIS SMALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
73 LENOX AVE, NEW YORK, NY 10026-3007
(212) 663-1596
(212) 663-1323
Mailing address
2255 HAVILAND AVE APT J, BRONX, NY 10462-5216
(212) 663-1596
(212) 663-1323
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20493
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20463
CASAC
NY
Enumeration date
05/21/2014
Last updated
05/21/2014
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