Provider Demographics
NPI:1427124833
Name:MCFALLS, PATRICK JOHN (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:MCFALLS
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 1:10 SHAG BARK LN
Mailing Address - Street 2:
Mailing Address - City:PENNELLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13132-3137
Mailing Address - Country:US
Mailing Address - Phone:315-676-3497
Mailing Address - Fax:
Practice Address - Street 1:74 BUNNER STREET
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126
Practice Address - Country:US
Practice Address - Phone:315-343-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074175-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical