Provider Demographics
NPI:1922161413
Name:HRACHIAN, CHARLENE ANN (MSW, LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:ANN
Last Name:HRACHIAN
Suffix:
Gender:F
Credentials:MSW, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WHEELER DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1814
Mailing Address - Country:US
Mailing Address - Phone:518-383-3994
Mailing Address - Fax:
Practice Address - Street 1:747 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3392
Practice Address - Country:US
Practice Address - Phone:518-427-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR030137-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical