Provider Demographics
NPI:1316382815
Name:MCINTOSH, NADLEY ROSE (LMSW)
Entity Type:Individual
Prefix:
First Name:NADLEY
Middle Name:ROSE
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4220 HUTCHINSON RIVER PKWY E
Mailing Address - Street 2:APT 26C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4726
Mailing Address - Country:US
Mailing Address - Phone:917-834-3784
Mailing Address - Fax:347-326-6414
Practice Address - Street 1:256 WASHINGTON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1052
Practice Address - Country:US
Practice Address - Phone:914-613-0693
Practice Address - Fax:914-237-7256
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0880991041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool