Provider Demographics
NPI:1851488654
Name:STAFFANELL, NORA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:
Last Name:STAFFANELL
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 1:13 ORCHARD TERRACE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3402
Mailing Address - Country:US
Mailing Address - Phone:845-783-9097
Mailing Address - Fax:845-783-1039
Practice Address - Street 1:13 ORCHARD TERRACE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3402
Practice Address - Country:US
Practice Address - Phone:845-783-9097
Practice Address - Fax:845-783-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0451551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN1C711Medicare PIN