Cultivating Growth Licensed Clinical Social Work, P.l.l.c. | |
301 S Geneva St Ithaca NY 14850-5445 | |
(607) 280-0550 | |
Not Available |
Full Name | Cultivating Growth Licensed Clinical Social Work, P.l.l.c. |
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Speciality | Community/behavioral Health |
Location | 301 S Geneva St, Ithaca, New York |
Authorized Official Name and Position | Andre L Williams (MEMBER) |
Authorized Official Contact | 6072800550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cultivating Growth Licensed Clinical Social Work, P.l.l.c. Po Box 722 Ithaca NY 14851-0722 Ph: () - | Cultivating Growth Licensed Clinical Social Work, P.l.l.c. 301 S Geneva St Ithaca NY 14850-5445 Ph: (607) 280-0550 |
NPI Number | 1932639200 |
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Provider Enumeration Date | 06/19/2017 |
Last Update Date | 06/19/2017 |
Identifier | Type | State | Issuer |
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1932639200 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 082085 (New York) | Primary |
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