| About Face Behavioral Health | |
|
32133 Nys Route 3 Carthage NY 13619-9524 | |
| (315) 405-7773 | |
| Not Available |
| Full Name | About Face Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 32133 Nys Route 3, Carthage, New York |
| Authorized Official Name and Position | Kenneth Charles Price (OWNER) |
| Authorized Official Contact | 3154057773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| About Face Behavioral Health Po Box 189 Felts Mills NY 13638-0189 Ph: (315) 405-7773 | About Face Behavioral Health 32133 Nys Route 3 Carthage NY 13619-9524 Ph: (315) 405-7773 |
| NPI Number | 1528457454 |
|---|---|
| Provider Enumeration Date | 01/15/2015 |
| Last Update Date | 01/15/2015 |
| Medicare PECOS PAC ID | 2668798497 |
|---|---|
| Medicare Enrollment ID | O20150313000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528457454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 077030 (New York) | Primary |
| Provider Name | Kenneth Charles Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902133622 PECOS PAC ID: 3577889302 Enrollment ID: I20150313000519 |
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