Provider Demographics
NPI:1295958817
Name:BARGEBUHR, NANCY ELLEN (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELLEN
Last Name:BARGEBUHR
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E 65TH ST
Mailing Address - Street 2:APARTMENT 2J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7127
Mailing Address - Country:US
Mailing Address - Phone:212-802-9307
Mailing Address - Fax:
Practice Address - Street 1:410 E 65TH ST
Practice Address - Street 2:APARTMENT 2J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7127
Practice Address - Country:US
Practice Address - Phone:212-802-9307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056421-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical