Provider Demographics
NPI:1326345356
Name:FLANAGAN, PATRICIA (LCSW, M ED)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:LCSW, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1202
Mailing Address - Country:US
Mailing Address - Phone:201-618-8814
Mailing Address - Fax:973-762-2001
Practice Address - Street 1:25 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081
Practice Address - Country:US
Practice Address - Phone:201-618-8814
Practice Address - Fax:973-762-2001
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ 44SC010134001041C0700X
NJNJ 44 SC010134001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical