Provider Demographics
NPI:1053017855
Name:DAGROSA, KIRSTEN MEGHAN (LCSW)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MEGHAN
Last Name:DAGROSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PARK PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4002
Mailing Address - Country:US
Mailing Address - Phone:347-563-3078
Mailing Address - Fax:
Practice Address - Street 1:1002 DEAN ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3303
Practice Address - Country:US
Practice Address - Phone:929-548-2339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0923791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical