Provider Demographics
NPI:1053336875
Name:LOARCA, CESAR AUGUSTO (LCSW)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:AUGUSTO
Last Name:LOARCA
Suffix:
Gender:M
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:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:SWAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12783-0340
Mailing Address - Country:US
Mailing Address - Phone:845-292-6880
Mailing Address - Fax:845-292-4652
Practice Address - Street 1:4404 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:SWAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:12283
Practice Address - Country:US
Practice Address - Phone:845-292-6880
Practice Address - Fax:845-292-4652
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0697541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY069754OtherDEPARTMENT OF EDUCATION