Provider Demographics
NPI:1154416832
Name:KNIFFIN, MARCY (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARCY
Middle Name:
Last Name:KNIFFIN
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 1:18 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2710
Mailing Address - Country:US
Mailing Address - Phone:845-309-4571
Mailing Address - Fax:845-223-5350
Practice Address - Street 1:1591 ROUTE 22
Practice Address - Street 2:C/O WHOLISTIC PHYSICAL THERAPY
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4026
Practice Address - Country:US
Practice Address - Phone:845-309-4571
Practice Address - Fax:845-940-1051
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041537-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical