Healthcare Provider Details

I. General information

NPI: 1720090426
Provider Name (Legal Business Name): PATRICIA JOY FINKENBERG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W HILL BLVD 437 MDOS/SGOH
CHARLESTON AFB SC
29404-4704
US

IV. Provider business mailing address

3262 JOHN BARTRAM PL
MT PLEASANT SC
29466-7083
US

V. Phone/Fax

Practice location:
  • Phone: 843-963-6972
  • Fax: 843-963-6501
Mailing address:
  • Phone: 843-856-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003652
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: