Provider Demographics
NPI:1417988049
Name:SACCARDI, PATRICIA ADELE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ADELE
Last Name:SACCARDI
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11934 NYS RT 9 N
Mailing Address - Street 2:
Mailing Address - City:UPPER JAY
Mailing Address - State:NY
Mailing Address - Zip Code:12983
Mailing Address - Country:US
Mailing Address - Phone:518-946-2628
Mailing Address - Fax:
Practice Address - Street 1:2217 STATE ROUTE 86
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5644
Practice Address - Country:US
Practice Address - Phone:518-891-5535
Practice Address - Fax:518-891-5851
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0421021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical