Provider Demographics
NPI:1366570830
Name:KOURY, NANCY JOAN (MSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JOAN
Last Name:KOURY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HALSEY DR
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-1228
Mailing Address - Country:US
Mailing Address - Phone:203-637-4475
Mailing Address - Fax:
Practice Address - Street 1:31 HALSEY DR
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1228
Practice Address - Country:US
Practice Address - Phone:203-637-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064197-1104100000X
CT0055901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical