MEDICARE: PATRICIA A BRESCIA-CANTINE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	I4467	NM
2	1041C0700X	Clinical Social Worker	075774	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861487175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA A BRESCIA-CANTINE LCSW

Provider Business Mailing Address
First Line	:	95 OHAYO MOUNTAIN RD
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-1441
Country	:	US
Telephone Number	:	845-399-4261
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 PINE GROVE ST
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-1507
Country	:	US
Telephone Number	:	845-679-5511
Fax Number	:	845-679-0324

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	11/10/2022

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