Healthcare Provider Details

I. General information

NPI: 1184529497
Provider Name (Legal Business Name): PATRISE HENRY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VAN WYCK EXPY
RICHMOND HILL NY
11418-2897
US

IV. Provider business mailing address

4610 CRANE ST APT 404
LONG ISLAND CITY NY
11101-4379
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-7135
  • Fax:
Mailing address:
  • Phone: 718-666-8615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133606
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: