Provider Demographics
NPI:1700095577
Name:DASHIELL, PATRICIA A (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:DASHIELL
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 PALMER AVENUE
Mailing Address - Street 2:142
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538
Mailing Address - Country:US
Mailing Address - Phone:914-632-3724
Mailing Address - Fax:
Practice Address - Street 1:2005 PALMER AVENUE
Practice Address - Street 2:142
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:315-219-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0522531104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN0J661Medicare ID - Type Unspecified