Provider Demographics
NPI:1518106848
Name:NISI, GERALDINE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:MARIE
Last Name:NISI
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 1:54 SPLIT LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5717
Mailing Address - Country:US
Mailing Address - Phone:914-954-4222
Mailing Address - Fax:
Practice Address - Street 1:199 MAIN ST
Practice Address - Street 2:STE 601
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3286
Practice Address - Country:US
Practice Address - Phone:914-954-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069906-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical