Provider Demographics
NPI:1497462717
Name:NAIR, VIDYA (MSW, LCWI)
Entity Type:Individual
Prefix:
First Name:VIDYA
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:MSW, LCWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 WHALE CAY WAY
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-1629
Mailing Address - Country:US
Mailing Address - Phone:561-460-8491
Mailing Address - Fax:
Practice Address - Street 1:143 WHALE CAY WAY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-1629
Practice Address - Country:US
Practice Address - Phone:561-460-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW175111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical