Provider Demographics
NPI:1962790980
Name:MCDEVITT, FIONA JUDSON (LCSW)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:JUDSON
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W STATE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5279
Mailing Address - Country:US
Mailing Address - Phone:607-227-8685
Mailing Address - Fax:
Practice Address - Street 1:430 W STATE ST STE 206
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5279
Practice Address - Country:US
Practice Address - Phone:607-227-8685
Practice Address - Fax:607-352-4677
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08217811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical