Provider Demographics
NPI:1093858284
Name:OGRADY, JOHN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:OGRADY
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 1:817 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2004
Mailing Address - Country:US
Mailing Address - Phone:518-438-2634
Mailing Address - Fax:518-452-4233
Practice Address - Street 1:148 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2901
Practice Address - Country:US
Practice Address - Phone:518-250-8676
Practice Address - Fax:518-452-4233
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0440101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical