Provider Demographics
NPI:1710023114
Name:DAVIDSON, NANCY S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:S
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ONE HALF ELD ST
Mailing Address - Street 2:REAR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3815
Mailing Address - Country:US
Mailing Address - Phone:203-494-6440
Mailing Address - Fax:718-407-4615
Practice Address - Street 1:115 E 23RD ST 12 FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4508
Practice Address - Country:US
Practice Address - Phone:203-494-6440
Practice Address - Fax:718-407-4615
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health