Provider Demographics
NPI:1043543903
Name:HUMM, PATRICIA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:HUMM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-5502
Mailing Address - Country:US
Mailing Address - Phone:716-488-1971
Mailing Address - Fax:716-488-9198
Practice Address - Street 1:332 EAST FOURTH ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14702-0457
Practice Address - Country:US
Practice Address - Phone:716-488-1971
Practice Address - Fax:716-488-1971
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081487-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52326AMedicare UPIN