Healthcare Provider Details

I. General information

NPI: 1750129342
Provider Name (Legal Business Name): JOAN ANN HORGAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 GREAT OAKS BLVD STE 215
ALBANY NY
12203-5969
US

IV. Provider business mailing address

66 FOREST AVE
ALBANY NY
12208-3020
US

V. Phone/Fax

Practice location:
  • Phone: 518-218-1188
  • Fax:
Mailing address:
  • Phone: 518-817-7472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: