Provider Demographics
NPI:1619057486
Name:SZOST, JOSEPH STEPHEN JR (LCSWR)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:SZOST
Suffix:JR
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:136 JAMESON HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12514-9650
Mailing Address - Country:US
Mailing Address - Phone:845-227-8903
Mailing Address - Fax:845-677-3694
Practice Address - Street 1:3712 ROUTE 44
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-0636
Practice Address - Country:US
Practice Address - Phone:845-227-8903
Practice Address - Fax:845-677-3694
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039393-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02037781Medicaid
NY02037781Medicaid