Provider Demographics
NPI:1073944823
Name:PARDY GINDA, JACQUELINE MICHELE (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:MICHELE
Last Name:PARDY GINDA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:PARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:CORNWALL ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12520-1114
Mailing Address - Country:US
Mailing Address - Phone:914-844-8420
Mailing Address - Fax:
Practice Address - Street 1:321 MAIN ST
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1503
Practice Address - Country:US
Practice Address - Phone:914-844-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR081350-11041C0700X, 1041S0200X
NY0813501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool