Provider Demographics
NPI:1356504823
Name:PACE, JOSEPH FRANK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANK
Last Name:PACE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAIN ST
Mailing Address - Street 2:LL 21
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-6606
Mailing Address - Country:US
Mailing Address - Phone:607-758-5423
Mailing Address - Fax:
Practice Address - Street 1:17 MAIN ST
Practice Address - Street 2:LL 21
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-6606
Practice Address - Country:US
Practice Address - Phone:607-758-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-05
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NY0709311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical