Provider Demographics
NPI:1184953424
Name:LOUKIDES, PATSY PAYNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:PAYNE
Last Name:LOUKIDES
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 1:215 BARTLEY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1243
Mailing Address - Country:US
Mailing Address - Phone:732-995-2265
Mailing Address - Fax:
Practice Address - Street 1:215 BARTLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1243
Practice Address - Country:US
Practice Address - Phone:732-995-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050140001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical