Provider Demographics
NPI:1164431698
Name:JAMES, PATRICIA LANGEVIN (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LANGEVIN
Last Name:JAMES
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 1:32 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2922
Mailing Address - Country:US
Mailing Address - Phone:860-722-3217
Mailing Address - Fax:860-688-0004
Practice Address - Street 1:32 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2922
Practice Address - Country:US
Practice Address - Phone:860-722-3217
Practice Address - Fax:860-688-0004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0041201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT62-28255Medicare UPIN
CT488647Medicare UPIN
CT221421Medicare UPIN
CT298536Medicare UPIN
CT2256254Medicare UPIN
CT140004120CT01Medicare UPIN