MEDICARE: MS. NANCY HUEBBE LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P062417-1	NY

General Provider Information

NPI Number	:	1699930503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY HUEBBE LCSW-R

Provider Business Mailing Address
First Line	:	967 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1526
Country	:	US
Telephone Number	:	845-279-0999
Fax Number	:	845-279-0009

Provider Business Practice Location Address
First Line	:	967 ROUTE 22
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1526
Country	:	US
Telephone Number	:	845-279-0999
Fax Number	:	845-279-0009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	11/06/2009

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