Provider Demographics
NPI:1265766406
Name:WOSLEGER, PATRICIA EILEEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:WOSLEGER
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 1:1236 PACIFIC ST APT 4G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3032
Mailing Address - Country:US
Mailing Address - Phone:917-763-1521
Mailing Address - Fax:
Practice Address - Street 1:1236 PACIFIC ST APT 4G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3032
Practice Address - Country:US
Practice Address - Phone:917-763-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72081580104100000X
NY0813951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker