Provider Demographics
NPI:1306112016
Name:NESS, NICOLE A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:A
Last Name:NESS
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 1:3901 INDEPENDENCE AVE
Mailing Address - Street 2:7F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1219
Mailing Address - Country:US
Mailing Address - Phone:607-727-7518
Mailing Address - Fax:
Practice Address - Street 1:521 W 239TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1205
Practice Address - Country:US
Practice Address - Phone:718-601-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0773271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker