Provider Demographics
NPI:1437515392
Name:NIEVES, BETZAIDA (LMSW)
Entity Type:Individual
Prefix:
First Name:BETZAIDA
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 SCHUMAN PL
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2032
Mailing Address - Country:US
Mailing Address - Phone:516-301-0315
Mailing Address - Fax:
Practice Address - Street 1:344 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3923
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042578-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker