Provider Demographics
NPI:1417088766
Name:INEZ, ADELA GARCES (LCSW)
Entity Type:Individual
Prefix:
First Name:ADELA
Middle Name:GARCES
Last Name:INEZ
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 1:557 W 187TH ST
Mailing Address - Street 2:3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1343
Mailing Address - Country:US
Mailing Address - Phone:212-928-5687
Mailing Address - Fax:
Practice Address - Street 1:2021 GRAND CONCOURSE
Practice Address - Street 2:ROOM 823
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4304
Practice Address - Country:US
Practice Address - Phone:718-960-0312
Practice Address - Fax:718-583-4080
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043490-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical