Provider Demographics
NPI:1558435461
Name:VARDARO, BETH (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:VARDARO
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:CHAMPAGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:341 LINKS DRIVE EAST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572
Mailing Address - Country:US
Mailing Address - Phone:516-678-1796
Mailing Address - Fax:516-678-1796
Practice Address - Street 1:341 LINKS DRIVE EAST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572
Practice Address - Country:US
Practice Address - Phone:516-678-1796
Practice Address - Fax:516-678-1796
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0529011104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7525540OtherAETNA
NY345864OtherMHN
NYN3G292OtherEMPIRE
NY7409005OtherVALUE OPTIONS
NYP668412OtherOXFORD