Provider Demographics
NPI:1316481856
Name:MESSINA, PATRICIA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:MESSINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:MARIE
Other - Last Name:MESSINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:7837 VENTURE CENTER WAY
Mailing Address - Street 2:APTARTMENT 5212
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7414
Mailing Address - Country:US
Mailing Address - Phone:724-301-0311
Mailing Address - Fax:
Practice Address - Street 1:7837 VENTURE CENTER WAY
Practice Address - Street 2:APTARTMENT 5212
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-7414
Practice Address - Country:US
Practice Address - Phone:724-301-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW125541041C0700X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children