Provider Demographics
NPI:1013367341
Name:GORDEYEVA, IRINA (LCSW)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:GORDEYEVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:IRINA
Other - Middle Name:
Other - Last Name:SERGIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 COURT STREET SUITE 42
Mailing Address - Street 2:CHENANGO COUNTY BEHAVIORAL HEALTH SERVICES
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815
Mailing Address - Country:US
Mailing Address - Phone:607-337-1600
Mailing Address - Fax:607-334-4519
Practice Address - Street 1:5 COURT STREET SUITE 42
Practice Address - Street 2:CHENANGO COUNTY BEHAVIORAL HEALTH SERVICES
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815
Practice Address - Country:US
Practice Address - Phone:607-337-1600
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089185-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical