Healthcare Provider Details
I. General information
NPI: 1407926462
Provider Name (Legal Business Name): PATRICIA SEESE MARGOLIN PHD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
551 SPRING VALLEY RD
PARAMUS NJ
07652-5647
US
IV. Provider business mailing address
551 SPRING VALLEY RD
PARAMUS NJ
07652-5647
US
V. Phone/Fax
- Phone: 201-262-3284
- Fax: 201-262-1163
- Phone: 201-262-3284
- Fax: 201-262-1163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | PR0158741 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 44SC00352400 |
| License Number State | NJ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 169287 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HEALTHNET |
| # 2 | |
| Identifier | P1119863 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | OXFORD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: