Provider Demographics
NPI:1841170602
Name:PECCHIA, NATHAN (LMSW)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:PECCHIA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 HANCOCK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-6077
Mailing Address - Country:US
Mailing Address - Phone:330-720-0473
Mailing Address - Fax:
Practice Address - Street 1:10470 QUEENS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3694
Practice Address - Country:US
Practice Address - Phone:866-404-6913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120617-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical