Provider Demographics
NPI:1699930503
Name:HUEBBE, NANCY (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HUEBBE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:NICKI
Other - Middle Name:
Other - Last Name:HUEBBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-S
Mailing Address - Street 1:967 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1526
Mailing Address - Country:US
Mailing Address - Phone:845-279-0999
Mailing Address - Fax:845-279-0009
Practice Address - Street 1:967 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1526
Practice Address - Country:US
Practice Address - Phone:845-279-0999
Practice Address - Fax:845-279-0009
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP062417-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ300000698Medicare PIN