Provider Demographics
NPI:1740495621
Name:DAVIS-KESSLER, NANCY HANNAH
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:HANNAH
Last Name:DAVIS-KESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:HANNAH
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:449 NEVERSINK DR
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-3801
Mailing Address - Country:US
Mailing Address - Phone:516-567-4488
Mailing Address - Fax:
Practice Address - Street 1:200 MIDWAY PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2642
Practice Address - Country:US
Practice Address - Phone:845-341-1134
Practice Address - Fax:845-341-1134
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0711001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical