Healthcare Provider Details

I. General information

NPI: 1730193194
Provider Name (Legal Business Name): DAVI E OSGOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GOLDEN HILL LN ULSTER COUNTY MENTAL HEALTH DEPARTMENT
KINGSTON NY
12401-6441
US

IV. Provider business mailing address

239 GOLDEN HILL LN ULSTER COUNTY MENTAL HEALTH DEPARTMENT
KINGSTON NY
12401-6441
US

V. Phone/Fax

Practice location:
  • Phone: 845-340-4163
  • Fax: 845-340-4094
Mailing address:
  • Phone: 845-340-4163
  • Fax: 845-340-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: