Provider Demographics
NPI:1548463896
Name:DREYER, NOREEN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:NOREEN
Middle Name:ANN
Last Name:DREYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NOREEN
Other - Middle Name:GRAYSON
Other - Last Name:DREYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1110
Mailing Address - Country:US
Mailing Address - Phone:631-256-6297
Mailing Address - Fax:
Practice Address - Street 1:752 VETERAN MEMORIAL HWY
Practice Address - Street 2:BLDG 15 NO COUNTY COMPLEX
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2300
Practice Address - Country:US
Practice Address - Phone:631-853-6341
Practice Address - Fax:631-853-6413
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05163311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473170Medicaid