Provider Demographics
NPI:1457518557
Name:KUUSISTO, PATRICIA KESSLER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:KESSLER
Last Name:KUUSISTO
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 1:34 S BROADWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4400
Mailing Address - Country:US
Mailing Address - Phone:914-948-9286
Mailing Address - Fax:
Practice Address - Street 1:34 S BROADWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4400
Practice Address - Country:US
Practice Address - Phone:914-948-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0177041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical