Fennell, Patricia A.

Fennell, Patricia A. is an individual health care provider with primary practice located at 582 New Loudon Rd , Latham NY 12110-4029. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fennell, Patricia A. can be contacted via phone (518) 482-0422.

Contact Information

Primary practice address
582 New Loudon Rd Latham NY 12110-4029
Phone: (518) 482-0422
Fax: (518) 783-4793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 031651 New York

Profile Details

NPI number 1598897662
LBN Legal business name Fennell, Patricia A.
Credentials LCSW-R
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2007
Last updated Nov 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598897662 NPPES
New York MEDICAID 01938458

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