Healthcare Provider Details

I. General information

NPI: 1669500476
Provider Name (Legal Business Name): PATRICIA ANNE GAFFNEY LCSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 SW MONTEREY RD
STUART FL
34994-4641
US

IV. Provider business mailing address

2596 SW REGENCY RD
STUART FL
34997-1222
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-7080
  • Fax: 772-781-8690
Mailing address:
  • Phone: 772-283-7080
  • Fax: 772-781-8690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW6871
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number03341
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: