Provider Demographics
NPI:1295818649
Name:WOOD, PATRICIA S I (LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:WOOD
Suffix:I
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 PORT WATSON ST
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-3026
Mailing Address - Country:US
Mailing Address - Phone:607-765-0398
Mailing Address - Fax:607-756-0398
Practice Address - Street 1:55 PORT WATSON ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-3026
Practice Address - Country:US
Practice Address - Phone:607-765-0398
Practice Address - Fax:607-756-0398
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000141-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health