Provider Demographics
NPI:1578587887
Name:BADAIN, ILENE MICHELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ILENE
Middle Name:MICHELLE
Last Name:BADAIN
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 1:7111 S GANNETT HILL RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512-9166
Mailing Address - Country:US
Mailing Address - Phone:585-374-8922
Mailing Address - Fax:
Practice Address - Street 1:VETERANS MEDICAL CENTER 400 FORT HILL AVENUE
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-393-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0415201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical