Provider Demographics
NPI:1366145476
Name:GOODROW, JOSEPH PATRICK (MSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:GOODROW
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MALONE BEHAVIORAL HEALTH URGENT CARE
Mailing Address - Street 2:125 FINNEY BLVD
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MALONE BEHAVIORAL HEALTH URGENT CARE
Practice Address - Street 2:125 FINNEY BLVD
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953
Practice Address - Country:US
Practice Address - Phone:518-483-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker