Provider Demographics
NPI:1710305321
Name:HAUS, PATRIZIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRIZIA
Middle Name:
Last Name:HAUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATRIZIA
Other - Middle Name:
Other - Last Name:TIBERIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2722 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1914
Mailing Address - Country:US
Mailing Address - Phone:607-760-4068
Mailing Address - Fax:
Practice Address - Street 1:2722 MANHATTAN DR
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-1914
Practice Address - Country:US
Practice Address - Phone:607-760-4068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0816981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical