Provider Demographics
NPI:1801995709
Name:PATYJEWICZ, JOSEPH (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:PATYJEWICZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MASON DR
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1318
Mailing Address - Country:US
Mailing Address - Phone:518-562-8982
Mailing Address - Fax:518-562-8982
Practice Address - Street 1:206 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1614
Practice Address - Country:US
Practice Address - Phone:518-566-6838
Practice Address - Fax:518-566-6846
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025133251E00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251E00000XAgenciesHome Health