| Kathy Penner, Lcsw, Pllc | |
|
5413 West Genesee Street Suite 101 Camillus NY 13031 | |
| (315) 870-8295 | |
| Not Available |
| Full Name | Kathy Penner, Lcsw, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5413 West Genesee Street, Camillus, New York |
| Authorized Official Name and Position | Kathy Penner (MEMBER/OWNER) |
| Authorized Official Contact | 3158708295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathy Penner, Lcsw, Pllc 5413 West Genesee Street Suite 101 Camillus NY 13031 Ph: (315) 807-8295 | Kathy Penner, Lcsw, Pllc 5413 West Genesee Street Suite 101 Camillus NY 13031 Ph: (315) 870-8295 |
| NPI Number | 1851036321 |
|---|---|
| Provider Enumeration Date | 04/29/2022 |
| Last Update Date | 04/29/2022 |
| Certification Date | 04/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851036321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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