Provider Demographics
NPI:1508292608
Name:LOVAGLIO, PATRICK SEAN (LMSW)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:SEAN
Last Name:LOVAGLIO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 HALESITE DR
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-2430
Mailing Address - Country:US
Mailing Address - Phone:716-432-7060
Mailing Address - Fax:
Practice Address - Street 1:47 HALESITE DR
Practice Address - Street 2:
Practice Address - City:SOUND BEACH
Practice Address - State:NY
Practice Address - Zip Code:11789-2430
Practice Address - Country:US
Practice Address - Phone:716-432-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089156104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker