Provider Demographics
NPI:1386742278
Name:BAECHER DISALVO, JOANNE MARY (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARY
Last Name:BAECHER DISALVO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2002
Mailing Address - Country:US
Mailing Address - Phone:914-478-0433
Mailing Address - Fax:
Practice Address - Street 1:111 KRAFT AVE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4141
Practice Address - Country:US
Practice Address - Phone:914-356-2402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR 018941-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical