Active NPI
Irene F Bardach, LCSW
- Clinical Social Worker
- Port Chester, NY
National Provider Identifier
1881029197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 081102-1
- Practice address
- 17 Spring St
Port Chester, NY 10573-4509 - Phone
- (914) 937-5877
- NPI assigned
- Sep 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 081102-1 | NY | Primary |
Addresses
Primary practice location
17 Spring St
Port Chester, NY 10573-4509
Mailing address
122 Ridgeview LN
Yorktown Heights, NY 10598-5319
Phone (914) 643-7940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 081102-1 | Other | LICENSED CLINICAL SOCIAL WORKER, THE UNIVERSITY OF THE STATE OF NEW YORK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081102-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378339200000",
"number": "1881029197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 RIDGEVIEW LN",
"city": "YORKTOWN HEIGHTS",
"state": "NY",
"postal_code": "105985319",
"telephone_number": "914-643-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 SPRING ST",
"city": "PORT CHESTER",
"state": "NY",
"postal_code": "105734509",
"telephone_number": "914-937-5877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDACH",
"first_name": "IRENE",
"middle_name": "F",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-05",
"last_updated": "2013-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "081102-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CLINICAL SOCIAL WORKER, THE UNIVERSITY OF THE STATE OF NEW YORK",
"identifier": "081102-1",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Chester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.