Provider Demographics
NPI:1407327349
Name:NAGGAR, NICOLE DINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DINA
Last Name:NAGGAR
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 1:5 INDEPENDENCE PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4316
Mailing Address - Country:US
Mailing Address - Phone:631-606-0381
Mailing Address - Fax:631-824-9000
Practice Address - Street 1:147 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLD SPRING HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11724-1425
Practice Address - Country:US
Practice Address - Phone:631-606-0381
Practice Address - Fax:631-824-9000
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR070453-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical