Provider Demographics
NPI:1821197294
Name:O'KANE, PATRICIA P (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:P
Last Name:O'KANE
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 1:600 GRACE LN
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1707
Mailing Address - Country:US
Mailing Address - Phone:215-823-4096
Mailing Address - Fax:215-823-4558
Practice Address - Street 1:UNIVERSITY AND WOODLAND AVES
Practice Address - Street 2:PHILADELPHIA VA MEDICAL CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-823-4096
Practice Address - Fax:215-823-4558
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0139011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical