| Breakthrough Counseling, Lcsw, Pllc | |
|
515 Pine St Jamestown NY 14701-5345 | |
| (716) 201-0015 | |
| Not Available |
| Full Name | Breakthrough Counseling, Lcsw, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 515 Pine St, Jamestown, New York |
| Authorized Official Name and Position | Craig Felton (OWNER) |
| Authorized Official Contact | 7166404418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Counseling, Lcsw, Pllc 515 Pine St Jamestown NY 14701-5345 Ph: (716) 201-0015 | Breakthrough Counseling, Lcsw, Pllc 515 Pine St Jamestown NY 14701-5345 Ph: (716) 201-0015 |
| NPI Number | 1487351565 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 2163881814 |
|---|---|
| Medicare Enrollment ID | O20230629000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487351565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Craig Robert Felton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689982316 PECOS PAC ID: 2668762287 Enrollment ID: I20160609000964 |
| Provider Name | Kellie M Sims |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790984748 PECOS PAC ID: 6608215934 Enrollment ID: I20240418002607 |
| Provider Name | Justine M Jock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699228346 PECOS PAC ID: 7416396759 Enrollment ID: I20240418002990 |
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