Provider Demographics
NPI:1003876327
Name:KRELL, NANCY JEAN (LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEAN
Last Name:KRELL
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 YACHT CLUB RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4518
Mailing Address - Country:US
Mailing Address - Phone:631-587-6272
Mailing Address - Fax:631-893-4912
Practice Address - Street 1:30 YACHT CLUB RD
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-4518
Practice Address - Country:US
Practice Address - Phone:631-587-6272
Practice Address - Fax:631-893-4912
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0302371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN7A151Medicare ID - Type UnspecifiedPROVIDER NUMBER