Provider Demographics
NPI:1720364409
Name:YAISH, NECHAMA SMADAR (LCSW-R)
Entity Type:Individual
Prefix:
First Name:NECHAMA SMADAR
Middle Name:
Last Name:YAISH
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:SMADAR
Other - Middle Name:
Other - Last Name:YAISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:88 JOHN STREET
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491
Mailing Address - Country:US
Mailing Address - Phone:828-550-5636
Mailing Address - Fax:828-586-6601
Practice Address - Street 1:88 JOHN STREET
Practice Address - Street 2:
Practice Address - City:WEST HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12491
Practice Address - Country:US
Practice Address - Phone:828-550-5636
Practice Address - Fax:828-586-6601
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR066310-11041C0700X
NCC0082131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical