Provider Demographics
NPI:1295556058
Name:BAUER, BETH (LMSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 80TH ST APT 12D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0742
Mailing Address - Country:US
Mailing Address - Phone:917-763-1780
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1917
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6629
Practice Address - Country:US
Practice Address - Phone:917-400-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical