Provider Demographics
NPI:1265466601
Name:NEZELEK, MARGARET A (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:NEZELEK
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 1:76 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1112
Mailing Address - Country:US
Mailing Address - Phone:607-563-4080
Mailing Address - Fax:607-563-4080
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1112
Practice Address - Country:US
Practice Address - Phone:607-563-4080
Practice Address - Fax:607-563-4080
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0440551101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY713336OtherMVP
NY7482523002OtherGHI
NY135251OtherCDPHP
NY748252300OtherVALUE OPTIONS-EMPIRE
NY748252300OtherVALUE OPTIONS-EMPIRE