| Wellness Therapy Services Lcsw, Pllc | |
|
2363 James St # 1122 Syracuse NY 13206-2840 | |
| (315) 030-1687 | |
| Not Available |
| Full Name | Wellness Therapy Services Lcsw, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 2363 James St # 1122, Syracuse, New York |
| Authorized Official Name and Position | Shannon Freeman (THERAPIST) |
| Authorized Official Contact | 3157030168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Therapy Services Lcsw, Pllc 2363 James St # 1122 Syracuse NY 13206-2840 Ph: (315) 703-0168 | Wellness Therapy Services Lcsw, Pllc 2363 James St # 1122 Syracuse NY 13206-2840 Ph: (315) 030-1687 |
| NPI Number | 1215405287 |
|---|---|
| Provider Enumeration Date | 11/08/2018 |
| Last Update Date | 12/22/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 6406193994 |
|---|---|
| Medicare Enrollment ID | O20190122001961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215405287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Shannon M Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467434712 PECOS PAC ID: 5294792115 Enrollment ID: I20041213000611 |
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