Provider Demographics
NPI:1083712913
Name:SEECOF, RONA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:RONA
Middle Name:
Last Name:SEECOF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RONA
Other - Middle Name:
Other - Last Name:SEECOF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3 FAMILY PRACTICE DRIVE
Mailing Address - Street 2:FAMILY PRACTICE CENTER
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-338-2562
Mailing Address - Fax:845-338-8909
Practice Address - Street 1:50 SHOPRITE BLVD
Practice Address - Street 2:ELLENVILLE HOSPITAL CAMPUS
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428
Practice Address - Country:US
Practice Address - Phone:845-647-4500
Practice Address - Fax:845-647-7632
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0406421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00733871Medicaid
N5G9512Medicare ID - Type Unspecified
NY00733871Medicaid