Provider Demographics
NPI:1831486943
Name:BAKST, NECHAMA R (LCSW)
Entity Type:Individual
Prefix:
First Name:NECHAMA
Middle Name:R
Last Name:BAKST
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 1:115 BENNETT AVE
Mailing Address - Street 2:12B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2303
Mailing Address - Country:US
Mailing Address - Phone:847-894-4343
Mailing Address - Fax:
Practice Address - Street 1:70 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5606
Practice Address - Country:US
Practice Address - Phone:914-636-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-10
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078037-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical