Provider Demographics
NPI:1265975254
Name:KESHODKAR, NADIA S (LCSW)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:S
Last Name:KESHODKAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:S
Other - Last Name:SHEIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:549 BORDEN AVE
Mailing Address - Street 2:APT 7E
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5883
Mailing Address - Country:US
Mailing Address - Phone:609-468-7571
Mailing Address - Fax:
Practice Address - Street 1:301 E 17TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-598-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0778721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical