Patricia A. Kissick, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R051904-1 Issued in NY

Practice address

3220 Pearl St
Endwell, NY 13760-5758

Phone

(607) 754-4520

Fax

(607) 754-4021

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285743302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-754-4520",
            "fax_number": "607-754-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-754-4520",
            "fax_number": "607-754-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSICK",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R051904-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Maria Kavanaugh, OPHTHALMIC DISPENSER
• Dawn Dolores Kerila, RN
• Istafro Michael Khalil
• Karoline Marielle Kies
• Sangmoon Kim, PH.D
• Ronald L. Kissick, LCSW
• Caitlyn Knapp, FNP-C, BSN, RN
• Deborah Ann Kollar, OTR/L
• Paul James Komatinsky, LCSW
• Jennifer R Kriebel

• Clinical Social Worker in Endwell, NY
• Providers in Endwell, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.