Provider Demographics
NPI:1861830523
Name:PAKATAR, JESSICA N (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:PAKATAR
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 1:1600 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-3410
Mailing Address - Country:US
Mailing Address - Phone:518-686-0694
Mailing Address - Fax:518-686-4862
Practice Address - Street 1:69 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HOOSICK FALLS
Practice Address - State:NY
Practice Address - Zip Code:12090-1642
Practice Address - Country:US
Practice Address - Phone:518-686-0694
Practice Address - Fax:518-686-4862
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085773-011041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical