Provider Demographics
NPI:1790422475
Name:OSSOWSKI, JOHN DEAN (LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DEAN
Last Name:OSSOWSKI
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 1:642 E GANSEVOORT ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1521
Mailing Address - Country:US
Mailing Address - Phone:315-269-9619
Mailing Address - Fax:
Practice Address - Street 1:1600 BURRSTONE RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4892
Practice Address - Country:US
Practice Address - Phone:315-792-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086827-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker