Healthcare Provider Details

I. General information

NPI: 1003077371
Provider Name (Legal Business Name): MICHAEL FOUHY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 FRANKLIN ST
SCHENECTADY NY
12305-2011
US

IV. Provider business mailing address

3015 VALLEY PINE DR
SCHENECTADY NY
12303-5414
US

V. Phone/Fax

Practice location:
  • Phone: 518-381-8911
  • Fax: 518-377-4292
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number73042854
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: