Provider Demographics
NPI:1700027596
Name:FOLEY, SEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 218TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1922
Mailing Address - Country:US
Mailing Address - Phone:718-454-9804
Mailing Address - Fax:718-454-9806
Practice Address - Street 1:8605 218TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1922
Practice Address - Country:US
Practice Address - Phone:718-454-9804
Practice Address - Fax:718-454-9806
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-152361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY87726OtherUNITED BEHAVIORAL HEALTH
NY12151001OtherMULTIPLAN
NY7405842OtherGHI
NY12151001OtherHIP
NYP00472672OtherRAILROAD MEDICARE
NY06927Medicare PIN