Provider Demographics
NPI:1699932152
Name:KADYSZEWSKI, BARBARA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:MARIE
Last Name:KADYSZEWSKI
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 1:427 GUY PARK AVE
Mailing Address - Street 2:MENTAL HEALTH ADULT CLINIC
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1054
Mailing Address - Country:US
Mailing Address - Phone:518-841-7361
Mailing Address - Fax:518-770-7536
Practice Address - Street 1:427 GUY PARK AVE
Practice Address - Street 2:MENTAL HEALTH ADULT CLINIC
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1054
Practice Address - Country:US
Practice Address - Phone:518-841-7361
Practice Address - Fax:518-770-7536
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074647-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health