Provider Demographics
NPI:1023380433
Name:MCCLOSKEY, TRICIA (LCSW, CASAC)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 DEEP LN
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1805
Mailing Address - Country:US
Mailing Address - Phone:516-404-9884
Mailing Address - Fax:
Practice Address - Street 1:27 DEEP LN
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1805
Practice Address - Country:US
Practice Address - Phone:516-404-9884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP78801104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTMCCLOSK123OtherMSW