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General NPI Number Information
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NPI Number | 1255470126
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Entity Type | Individual
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Provider Name | JOHN JOSEPH HARTIGAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 40 NORTH MAIN AVENUE COUNSELING FOR LAITY-ROMAN CATHOLIC DIOCESE PASTORAL CT
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City | ALBANY
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State | NY
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Zip | 12203
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Country | US
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Telephone | 518-453-6625
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Fax |
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Provider Business Mailing Address
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Address Line | 815 TROTTINGHAM DR
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City | NISKAYUNA
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State | NY
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Zip | 12309-3013
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Country | US
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Telephone | 518-859-7843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R043743-1
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License Number State | NY
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