Provider Demographics
NPI:1093802308
Name:SANTOS, NANCY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:SANTOS
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 1:2977 BAINBRIDGE AVE APT 505
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2140
Mailing Address - Country:US
Mailing Address - Phone:718-220-0039
Mailing Address - Fax:
Practice Address - Street 1:4123 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6222
Practice Address - Country:US
Practice Address - Phone:718-299-3045
Practice Address - Fax:718-716-2604
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73-0542911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical