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241 Wildwood Rdg Frankfort NY 13340-9109 | |
| (315) 520-0859 | |
| (315) 316-0001 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 241 Wildwood Rdg, Frankfort, New York |
| Authorized Official Name and Position | Luis Daniel Ramirez (CEO / LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 3155200859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
241 Wildwood Rdg Frankfort NY 13340-9109 Ph: (315) 520-0859 | 241 Wildwood Rdg Frankfort NY 13340-9109 Ph: (315) 520-0859 |
| NPI Number | 1114590163 |
|---|---|
| Provider Enumeration Date | 07/19/2021 |
| Last Update Date | 12/19/2024 |
| Certification Date | 12/19/2024 |
| Medicare PECOS PAC ID | 3971992462 |
|---|---|
| Medicare Enrollment ID | O20211123001601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114590163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Luis Daniel Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982255931 PECOS PAC ID: 5799174280 Enrollment ID: I20211123001687 |
| Provider Name | Christina Reap |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871080812 PECOS PAC ID: 9133581721 Enrollment ID: I20230814003350 |
| Provider Name | Sabrina Wing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871142026 PECOS PAC ID: 5597128140 Enrollment ID: I20230829003940 |