Provider Demographics
NPI:1053659375
Name:CHAIFETZ, NINA (LCSW)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:CHAIFETZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 DOBBS FERRY RD
Mailing Address - Street 2:303
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1900
Mailing Address - Country:US
Mailing Address - Phone:917-553-0091
Mailing Address - Fax:845-480-5116
Practice Address - Street 1:1133 BROADWAY STE 529
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8095
Practice Address - Country:US
Practice Address - Phone:914-505-6621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73920001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical