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1646 Ulster Heights Rd Ellenville NY 12428-5733 | |
(860) 995-3457 | |
(888) 975-1417 |
Full Name | |
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Speciality | Social Worker |
Location | 1646 Ulster Heights Rd, Ellenville, New York |
Authorized Official Name and Position | Debra Franklin (OWNER) |
Authorized Official Contact | 8609953457 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1646 Ulster Heights Rd Ellenville NY 12428-5733 Ph: (860) 995-3457 | 1646 Ulster Heights Rd Ellenville NY 12428-5733 Ph: (860) 995-3457 |
NPI Number | 1083080733 |
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Provider Enumeration Date | 08/17/2015 |
Last Update Date | 12/23/2024 |
Certification Date | 12/23/2024 |
Medicare PECOS PAC ID | 5193035194 |
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Medicare Enrollment ID | O20151103002037 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083080733 | NPI | - | NPPES |
5592636 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Debra Franklin |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1720101520 PECOS PAC ID: 1254482755 Enrollment ID: I20090623000591 |
Jasforensics, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 190 Seigel Rd, Ellenville, NY 12428 Phone: 917-346-7479 |