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General NPI Number Information
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NPI Number | 1932019676
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Entity Type | Individual
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Provider Name | MARYKATHLEEN CLASSEY
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Gender | Female
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 375 BAY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-3012
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Country | US
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Telephone | 518-798-4496
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Fax |
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Provider Business Mailing Address
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Address Line | 763 COUNTY ROUTE 43
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City | FORT EDWARD
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State | NY
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Zip | 12828-3921
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Country | US
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Telephone | 203-470-7093
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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