Essentia Telehealth Wellness, Lcsw, Pllc | |
110 Mechanic St Fayetteville NY 13066-1333 | |
(505) 365-1519 | |
Not Available |
Full Name | Essentia Telehealth Wellness, Lcsw, Pllc |
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Speciality | Social Worker - Clinical |
Location | 110 Mechanic St, Fayetteville, New York |
Authorized Official Name and Position | Enrique Antonio Rosario (CO-OWNER) |
Authorized Official Contact | 5053651519 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Essentia Telehealth Wellness, Lcsw, Pllc 110 Mechanic St Fayetteville NY 13066-1333 Ph: (505) 365-1519 | Essentia Telehealth Wellness, Lcsw, Pllc 110 Mechanic St Fayetteville NY 13066-1333 Ph: (505) 365-1519 |
NPI Number | 1184459448 |
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Provider Enumeration Date | 09/05/2024 |
Last Update Date | 09/05/2024 |
Certification Date | 09/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184459448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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