Provider Demographics
NPI:1033685813
Name:SAN ANTONIO, JOSEPH FRANCIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:SAN ANTONIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:12853-2304
Mailing Address - Country:US
Mailing Address - Phone:518-251-2921
Mailing Address - Fax:518-251-2087
Practice Address - Street 1:165 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853-2304
Practice Address - Country:US
Practice Address - Phone:518-251-2921
Practice Address - Fax:518-251-2087
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0943241041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool