Provider Demographics
NPI:1992909253
Name:BAIREY, ZIVIA (CREATIVE A T SOC WKR)
Entity type:Individual
Prefix:MS
First Name:ZIVIA
Middle Name:
Last Name:BAIREY
Suffix:
Gender:F
Credentials:CREATIVE A T SOC WKR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27020 CEDAR RD APT 117-1
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1136
Mailing Address - Country:US
Mailing Address - Phone:917-518-8595
Mailing Address - Fax:216-765-0451
Practice Address - Street 1:17 RISLEY PLACE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-632-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCAT000015221700000X
OHI 07000151041C0700X
NYLCSW0758601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist