Provider Demographics
NPI:1538273594
Name:BERNSTEIN, NANCY G (LCSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:G
Last Name:BERNSTEIN
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 1:10 E 29TH ST APT 43C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7445
Mailing Address - Country:US
Mailing Address - Phone:917-991-0840
Mailing Address - Fax:212-545-0815
Practice Address - Street 1:136 MADISON AVE STE 530
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6711
Practice Address - Country:US
Practice Address - Phone:917-991-0840
Practice Address - Fax:212-545-0815
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0240471041C0700X
NYLCSWR024047-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N42821Medicare ID - Type Unspecified