| White Tara Therapy Llc | |
|
45 Clark Rd Eldred NY 12732-5012 | |
| (845) 741-8898 | |
| Not Available |
| Full Name | White Tara Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 Clark Rd, Eldred, New York |
| Authorized Official Name and Position | Philip A Zuckerman (OWNER) |
| Authorized Official Contact | 8457418898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Tara Therapy Llc 45 Clark Rd Eldred NY 12732-5012 Ph: (845) 741-8898 | White Tara Therapy Llc 45 Clark Rd Eldred NY 12732-5012 Ph: (845) 741-8898 |
| NPI Number | 1043071731 |
|---|---|
| Provider Enumeration Date | 01/19/2024 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Medicare PECOS PAC ID | 4789023664 |
|---|---|
| Medicare Enrollment ID | O20240412000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043071731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Philip Alan Zuckerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144383563 PECOS PAC ID: 2264492982 Enrollment ID: I20140313000710 |
Highland Counseling Services Lcsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 585 Rte. 55, Eldred, NY 12732 Phone: 845-699-8036 |