MEDICARE: MARIE WARCHOL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	027690	NY

General Provider Information

NPI Number	:	1093861155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE WARCHOL LCSW

Provider Business Mailing Address
First Line	:	17 VAN ALST ST
Second Line	:
City	:	NEW PALTZ
State	:	NY
Zip	:	12561
Country	:	US
Telephone Number	:	845-255-7469
Fax Number	:

Provider Business Practice Location Address
First Line	:	276 HUDSON STREET
Second Line	:	HUDSON CENTER
City	:	CORNWALL ON HUDSON
State	:	NY
Zip	:	12520
Country	:	US
Telephone Number	:	845-534-2926
Fax Number	:	845-534-3518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/13/2012

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