Provider Demographics
NPI:1548285885
Name:MCNAMARA, PATRICIA (LCSWR)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 STOCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9421
Mailing Address - Country:US
Mailing Address - Phone:518-489-1660
Mailing Address - Fax:518-458-8723
Practice Address - Street 1:2 TOWER PL
Practice Address - Street 2:EXECUTIVE PARK STUYVESANT PLAZA
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3735
Practice Address - Country:US
Practice Address - Phone:518-489-1660
Practice Address - Fax:518-458-8723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW-R043681104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56896BMedicare ID - Type Unspecified