Individual provider · NPI-1

Nicole Brander, LMSW

Social Worker, Clinical · Islandia, NY

NPI number1265200034
StatusActive
Last updated in NPPESDec 12, 2023

Details

NPI
1265200034
Entity type
Individual (NPI-1)
Name
Nicole Brander
Credential
LMSW
Sex
Female
Sole proprietor
No
Enumeration date
Dec 12, 2023
Certification date
Dec 12, 2023
Last updated
Dec 12, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical120630-01NYYes

Practice location

1777 Veterans Memorial Hwy Ste 14
Islandia, NY 11749-1555

Phone 631-212-2405

Mailing address

1777 Veterans Memorial Hwy Ste 14
Islandia, NY 11749-1555

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