| Jill Van Pelt Lcsw Pllc | |
|
4513 Old Vestal Rd Vestal NY 13850-3571 | |
| (607) 729-7001 | |
| (607) 729-6434 |
| Full Name | Jill Van Pelt Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4513 Old Vestal Rd, Vestal, New York |
| Authorized Official Name and Position | Jill A Meskunas-van Pelt (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6075959120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Van Pelt Lcsw Pllc 29 Downs Ave Binghamton NY 13905-1822 Ph: (607) 595-9120 | Jill Van Pelt Lcsw Pllc 4513 Old Vestal Rd Vestal NY 13850-3571 Ph: (607) 729-7001 |
| NPI Number | 1992119283 |
|---|---|
| Provider Enumeration Date | 06/16/2014 |
| Last Update Date | 06/16/2014 |
| Medicare PECOS PAC ID | 0345461836 |
|---|---|
| Medicare Enrollment ID | O20141027001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992119283 | NPI | - | NPPES |
| 03115804 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R069978 (New York) | Primary |
| Provider Name | Jill A Meskunas Van Pelt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740225671 PECOS PAC ID: 8123099520 Enrollment ID: I20040802000071 |
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