Provider Demographics
NPI:1477528685
Name:WOHL, NANCY L (LCSW, MA, CGP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:L
Last Name:WOHL
Suffix:
Gender:F
Credentials:LCSW, MA, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18311A 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2208
Mailing Address - Country:US
Mailing Address - Phone:718-357-0707
Mailing Address - Fax:718-357-4455
Practice Address - Street 1:11109 76TH RD
Practice Address - Street 2:SUITE #E5
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6424
Practice Address - Country:US
Practice Address - Phone:718-357-0707
Practice Address - Fax:718-357-4455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0580611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07042Medicare ID - Type UnspecifiedGHI- Q41316