Healthcare Provider Details

I. General information

NPI: 1386761658
Provider Name (Legal Business Name): PATRICIA A VOLPE LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 KETCHAM AVE
PATCHOGUE NY
11772-2549
US

IV. Provider business mailing address

146 KETCHAM AVE
PATCHOGUE NY
11772-2549
US

V. Phone/Fax

Practice location:
  • Phone: 631-569-2858
  • Fax: 631-569-4280
Mailing address:
  • Phone: 631-569-2858
  • Fax: 631-569-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070810
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: