Provider Demographics
NPI:1962582478
Name:SOLFARO, JUDITH MARIE (LCSW LICENSED CLINIC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MARIE
Last Name:SOLFARO
Suffix:
Gender:F
Credentials:LCSW LICENSED CLINIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BIRCHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7439
Mailing Address - Country:US
Mailing Address - Phone:845-863-0352
Mailing Address - Fax:845-863-0352
Practice Address - Street 1:71 BIRCHWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7439
Practice Address - Country:US
Practice Address - Phone:845-863-0352
Practice Address - Fax:845-863-0352
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR05173511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical