Provider Demographics
NPI:1659773810
Name:ERCEG, NORA LYNN (LCSW-R)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:LYNN
Last Name:ERCEG
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:LYNN
Other - Last Name:SEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:13841-0164
Mailing Address - Country:US
Mailing Address - Phone:607-656-5766
Mailing Address - Fax:
Practice Address - Street 1:425 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1775
Practice Address - Country:US
Practice Address - Phone:607-773-4250
Practice Address - Fax:607-773-4527
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0875381041C0700X
NY089391104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker