Provider Demographics
NPI:1427344464
Name:LACONTE, SHARLENE A (CSW)
Entity type:Individual
Prefix:
First Name:SHARLENE
Middle Name:A
Last Name:LACONTE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:CLAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13322-0492
Mailing Address - Country:US
Mailing Address - Phone:315-368-7005
Mailing Address - Fax:315-338-5407
Practice Address - Street 1:610 FRENCH RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1014
Practice Address - Country:US
Practice Address - Phone:315-738-1662
Practice Address - Fax:315-338-5407
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR026555-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical