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1500 Genesee St Utica NY 13502-5104 | |
| (315) 735-9501 | |
| (315) 735-9769 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1500 Genesee St, Utica, New York |
| Authorized Official Name and Position | James E Klein (DIRECTOR) |
| Authorized Official Contact | 3157359501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1500 Genesee St Utica NY 13502-5104 Ph: (315) 735-9501 | 1500 Genesee St Utica NY 13502-5104 Ph: (315) 735-9501 |
| NPI Number | 1083722979 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 06/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083722979 | NPI | - | NPPES |
| 01158465 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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