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NPI Code Detail

MEDICARE: MS. KATHLEEN EUGENIE PRATT LCSW

MEDICARE: MS. KATHLEEN EUGENIE PRATT 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
11041C0700XClinical Social WorkerR028843NY

General Provider Information

NPI Number : 1912155391
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN EUGENIE PRATT LCSW
Provider Business Mailing Address
First Line : 60 ACADEMY RD
Second Line :
City : ALBANY
State : NY
Zip : 12208-3103
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60 ACADEMY RD
Second Line :
City : ALBANY
State : NY
Zip : 12208-3103
Country : US
Telephone Number : 518-426-2811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2008
Last Update Date : 08/28/2008

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