Provider Demographics
NPI:1568530921
Name:MCBRIDE, JANET (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:MCBRIDE
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:PO BOX 1253
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-1253
Mailing Address - Country:US
Mailing Address - Phone:845-340-4080
Mailing Address - Fax:845-340-4070
Practice Address - Street 1:239 GOLDEN HILL LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6441
Practice Address - Country:US
Practice Address - Phone:845-340-4080
Practice Address - Fax:845-340-4070
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR071353-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN553T1Medicare ID - Type Unspecified