Provider Demographics
NPI:1609693456
Name:WARNER, DWAYNE ALEXANDER JR (NYCPS-4938)
Entity type:Individual
Prefix:MR
First Name:DWAYNE
Middle Name:ALEXANDER
Last Name:WARNER
Suffix:JR
Gender:M
Credentials:NYCPS-4938
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W 35TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-0216
Mailing Address - Country:US
Mailing Address - Phone:212-576-4121
Mailing Address - Fax:
Practice Address - Street 1:213 W 35TH ST STE 302
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-0216
Practice Address - Country:US
Practice Address - Phone:212-576-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYCPS-4938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health