Provider Demographics
NPI:1770832420
Name:BAYERSDORFER, NANCY (LCSW,CSSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BAYERSDORFER
Suffix:
Gender:F
Credentials:LCSW,CSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HAIGHT RD
Mailing Address - Street 2:
Mailing Address - City:AMENIA
Mailing Address - State:NY
Mailing Address - Zip Code:12501-5234
Mailing Address - Country:US
Mailing Address - Phone:845-373-4114
Mailing Address - Fax:
Practice Address - Street 1:194 HAIGHT RD
Practice Address - Street 2:
Practice Address - City:AMENIA
Practice Address - State:NY
Practice Address - Zip Code:12501-5234
Practice Address - Country:US
Practice Address - Phone:845-373-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-09
Last Update Date:2012-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO16205-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical