Provider Demographics
NPI:1346528445
Name:NARDO, MARCIA (CASAC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:NARDO
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4067
Mailing Address - Country:US
Mailing Address - Phone:212-925-6671
Mailing Address - Fax:212-925-8350
Practice Address - Street 1:251 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4067
Practice Address - Country:US
Practice Address - Phone:212-925-6671
Practice Address - Fax:212-925-8350
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11185101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)