| Gorham Mental Health Counseling, Pllc | |
|
721 Idlewood Blvd Baldwinsville NY 13027-3010 | |
| (315) 559-4303 | |
| Not Available |
| Full Name | Gorham Mental Health Counseling, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 721 Idlewood Blvd, Baldwinsville, New York |
| Authorized Official Name and Position | Jilleen E Gorham (OWNER) |
| Authorized Official Contact | 3155594303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gorham Mental Health Counseling, Pllc 721 Idlewood Blvd Baldwinsville NY 13027-3010 Ph: (315) 559-4303 | Gorham Mental Health Counseling, Pllc 721 Idlewood Blvd Baldwinsville NY 13027-3010 Ph: (315) 559-4303 |
| NPI Number | 1124703947 |
|---|---|
| Provider Enumeration Date | 06/19/2023 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124703947 | NPI | - | NPPES |
| 1164076097 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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