Provider Demographics
NPI:1447513650
Name:MCLOUGHLIN, PATRICIA (MSED)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5315
Mailing Address - Country:US
Mailing Address - Phone:718-807-5494
Mailing Address - Fax:
Practice Address - Street 1:45 COVERT PL
Practice Address - Street 2:
Practice Address - City:STEWART MANOR
Practice Address - State:NY
Practice Address - Zip Code:11530-3828
Practice Address - Country:US
Practice Address - Phone:516-233-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1447513650103K00000X
NY348501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist