Provider Demographics
NPI:1912560004
Name:PATRONSKI, STEFAN (LCSW)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:
Last Name:PATRONSKI
Suffix:
Gender:M
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:PO BOX 974
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-0974
Mailing Address - Country:US
Mailing Address - Phone:585-209-3609
Mailing Address - Fax:
Practice Address - Street 1:4094 ONNALINDA DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-8231
Practice Address - Country:US
Practice Address - Phone:585-209-3609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087387-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical