Provider Demographics
NPI:1114077500
Name:CURRIER, JACQUELINE M (LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:M
Last Name:CURRIER
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 1:291 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-3203
Mailing Address - Country:US
Mailing Address - Phone:607-431-9315
Mailing Address - Fax:
Practice Address - Street 1:64 MAIN ST STE 213
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2656
Practice Address - Country:US
Practice Address - Phone:607-267-6342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072634-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55922BMedicare ID - Type UnspecifiedPROVIDER NUMBER