Provider Demographics
NPI:1134219496
Name:O'FLAHERTY, LUCY L (LCSW)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:L
Last Name:O'FLAHERTY
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 1:18 PINE AVE
Mailing Address - Street 2:F.E.G.S. 445 OAK STREET COPIAGUE, NY LL726
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-1212
Mailing Address - Country:US
Mailing Address - Phone:516-827-0705
Mailing Address - Fax:516-827-0705
Practice Address - Street 1:18 PINE AVE
Practice Address - Street 2:F.E.G.S. 445 OAK STREET COPIAGUE, NY LL726
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-1212
Practice Address - Country:US
Practice Address - Phone:516-827-0705
Practice Address - Fax:516-827-0705
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPO456901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01948416Medicaid
NYN3M901Medicare ID - Type Unspecified