Provider Demographics
NPI:1023157609
Name:MACKLER, DANIEL D (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:D
Last Name:MACKLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 W 11TH ST
Mailing Address - Street 2:#2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2336
Mailing Address - Country:US
Mailing Address - Phone:212-243-5838
Mailing Address - Fax:
Practice Address - Street 1:321 W 11TH ST
Practice Address - Street 2:#2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2336
Practice Address - Country:US
Practice Address - Phone:212-243-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP063368-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02499392Medicaid
NY353134OtherMHN PROVIDER ID #
NYP3524256OtherOXFORD PROVIDER ID #
NYNY5822Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER