Provider Demographics
NPI:1033294848
Name:COONEY, ERIN MARIE (LCSW - R)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:COONEY
Suffix:
Gender:F
Credentials:LCSW - R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22850 FRALICK RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-9355
Mailing Address - Country:US
Mailing Address - Phone:315-786-1767
Mailing Address - Fax:315-786-1856
Practice Address - Street 1:171 E HOARD ST
Practice Address - Street 2:NORTH ELEMENTARY - CHILDRENS CLINIC
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-1515
Practice Address - Country:US
Practice Address - Phone:315-786-1767
Practice Address - Fax:315-786-1856
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR070100-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical