Provider Demographics
NPI:1316247075
Name:BARNES-PATTERSON, STEPHORNA PATRICIA (LMSW)
Entity type:Individual
Prefix:
First Name:STEPHORNA
Middle Name:PATRICIA
Last Name:BARNES-PATTERSON
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 1:77 PINELAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3901
Mailing Address - Country:US
Mailing Address - Phone:844-538-2735
Mailing Address - Fax:516-519-8113
Practice Address - Street 1:77 PINELAKE DR
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3901
Practice Address - Country:US
Practice Address - Phone:844-538-2735
Practice Address - Fax:516-519-8113
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081703104100000X, 1041S0200X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator