Provider Demographics
NPI:1740449438
Name:BRIEADDY, JOAN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:BRIEADDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:DYMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:742 JAMES STREET
Mailing Address - Street 2:ST JOSEPHS HOSPITAL HEALTH CENTER MENTAL HEALTH SERVICE
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203
Mailing Address - Country:US
Mailing Address - Phone:315-703-2700
Mailing Address - Fax:315-703-2730
Practice Address - Street 1:742 JAMES STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203
Practice Address - Country:US
Practice Address - Phone:315-703-2700
Practice Address - Fax:315-703-2730
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0745341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical