Provider Demographics
NPI:1104860485
Name:ALTMANN, VIRGINIA LORRAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:LORRAINE
Last Name:ALTMANN
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 1:16111 STATE HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-3214
Mailing Address - Country:US
Mailing Address - Phone:607-865-7656
Mailing Address - Fax:607-865-7659
Practice Address - Street 1:34570 STATE HIGHWAY 10
Practice Address - Street 2:SUITE 5
Practice Address - City:HAMDEN
Practice Address - State:NY
Practice Address - Zip Code:13782-1120
Practice Address - Country:US
Practice Address - Phone:607-865-7656
Practice Address - Fax:607-865-7659
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR058559-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical