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General NPI Number Information
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NPI Number | 1073944823
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Entity Type | Individual
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Provider Name | JACQUELINE MICHELE PARDY GINDA LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 321 MAIN ST
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City | CORNWALL
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State | NY
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Zip | 12518-1503
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Country | US
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Telephone | 914-844-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 11 PROSPECT ST
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City | CORNWALL ON HUDSON
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State | NY
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Zip | 12520-1114
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Country | US
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Telephone | 914-844-8420
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R081350-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | R081350-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 081350
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License Number State | NY
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