| Childers Professional Service Llc | |
|
27 Joshua Ln Central Square NY 13036-2176 | |
| (315) 383-7531 | |
| (315) 676-0014 |
| Full Name | Childers Professional Service Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 27 Joshua Ln, Central Square, New York |
| Authorized Official Name and Position | Daniel Joseph Childers (DIRECTOR) |
| Authorized Official Contact | 3153837531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childers Professional Service Llc Po Box738 Brewerton NY 13029 Ph: (315) 383-7531 | Childers Professional Service Llc 27 Joshua Ln Central Square NY 13036-2176 Ph: (315) 383-7531 |
| NPI Number | 1548705064 |
|---|---|
| Provider Enumeration Date | 12/20/2016 |
| Last Update Date | 12/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548705064 | NPI | - | NPPES |
| 02426997 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0574061 (New York) | Primary |
Cny True North Mental Health Counseling, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 662 S Main St Ste 3, Central Square, NY 13036 Phone: 757-646-5861 |