Provider Demographics
NPI:1063051779
Name:HLADUN, DEVIN (LMSW)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:HLADUN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-4528
Mailing Address - Country:US
Mailing Address - Phone:315-335-9497
Mailing Address - Fax:
Practice Address - Street 1:6075 JUDD RD
Practice Address - Street 2:
Practice Address - City:ORISKANY
Practice Address - State:NY
Practice Address - Zip Code:13424-4218
Practice Address - Country:US
Practice Address - Phone:315-768-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106641-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker