| Adirondack Counseling Traci Phillips Lcsw Pllc | |
|
565 Bay Rd Queensbury NY 12804-1443 | |
| (518) 321-1380 | |
| (518) 797-1599 |
| Full Name | Adirondack Counseling Traci Phillips Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 565 Bay Rd, Queensbury, New York |
| Authorized Official Name and Position | Traci Phillips (OWNER) |
| Authorized Official Contact | 5183211380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adirondack Counseling Traci Phillips Lcsw Pllc 565 Bay Rd Queensbury NY 12804-1443 Ph: (518) 321-1380 | Adirondack Counseling Traci Phillips Lcsw Pllc 565 Bay Rd Queensbury NY 12804-1443 Ph: (518) 321-1380 |
| NPI Number | 1548964745 |
|---|---|
| Provider Enumeration Date | 03/30/2023 |
| Last Update Date | 03/31/2023 |
| Certification Date | 03/31/2023 |
| Medicare PECOS PAC ID | 2961853171 |
|---|---|
| Medicare Enrollment ID | O20240111002146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548964745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Traci L Phillips-perkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295027217 PECOS PAC ID: 5193902609 Enrollment ID: I20110610000103 |
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