Provider Demographics
NPI:1942530183
Name:PUTMAN, CHAD EDWARD (MSW)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:EDWARD
Last Name:PUTMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 NEW LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4002
Mailing Address - Country:US
Mailing Address - Phone:518-783-5381
Mailing Address - Fax:
Practice Address - Street 1:636 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4002
Practice Address - Country:US
Practice Address - Phone:518-783-5381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker