Provider Demographics
NPI:1790808806
Name:DURK, ARLENE G (LCSW-R)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:G
Last Name:DURK
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 476
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-0476
Mailing Address - Country:US
Mailing Address - Phone:845-878-9078
Mailing Address - Fax:
Practice Address - Street 1:40 JON BARRETT RD
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2164
Practice Address - Country:US
Practice Address - Phone:845-878-9078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0742201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5R32EM751Medicare PIN