| Jennifer A. Crider, Lcsw, Pllc | |
|
135 Old Cove Rd Ste 208 Liverpool NY 13090-3775 | |
| (315) 944-0379 | |
| Not Available |
| Full Name | Jennifer A. Crider, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 135 Old Cove Rd Ste 208, Liverpool, New York |
| Authorized Official Name and Position | Jennifer A Crider (OWNER) |
| Authorized Official Contact | 3159440379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer A. Crider, Lcsw, Pllc 4985 Blacksmith Path Liverpool NY 13088-4703 Ph: (315) 944-0379 | Jennifer A. Crider, Lcsw, Pllc 135 Old Cove Rd Ste 208 Liverpool NY 13090-3775 Ph: (315) 944-0379 |
| NPI Number | 1093305708 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 03/05/2023 |
| Certification Date | 03/05/2023 |
| Medicare PECOS PAC ID | 8921413956 |
|---|---|
| Medicare Enrollment ID | O20210224001876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093305708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer A Crider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891316964 PECOS PAC ID: 9830504869 Enrollment ID: I20210224001942 |
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