Provider Demographics
NPI:1659055630
Name:CALIXTO, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CALIXTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 LOCKWOOD AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5080
Mailing Address - Country:US
Mailing Address - Phone:914-346-1056
Mailing Address - Fax:
Practice Address - Street 1:20 S BROADWAY # 3
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3713
Practice Address - Country:US
Practice Address - Phone:914-964-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker