| Wingspan Counseling Lcsw Pllc | |
|
95 Allens Creek Rd Ste 9 Rochester NY 14618-3252 | |
| (585) 568-7864 | |
| (855) 523-1669 |
| Full Name | Wingspan Counseling Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 95 Allens Creek Rd Ste 9, Rochester, New York |
| Authorized Official Name and Position | Sharon Dawn Mattsson (ORIGINAL MEMBER/MANAGER/ LCSW) |
| Authorized Official Contact | 5855687864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wingspan Counseling Lcsw Pllc 95 Allens Creek Rd Ste 9 Rochester NY 14618-3252 Ph: (585) 568-7864 | Wingspan Counseling Lcsw Pllc 95 Allens Creek Rd Ste 9 Rochester NY 14618-3252 Ph: (585) 568-7864 |
| NPI Number | 1013691344 |
|---|---|
| Provider Enumeration Date | 06/15/2023 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Medicare PECOS PAC ID | 2466816087 |
|---|---|
| Medicare Enrollment ID | O20230915001407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013691344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Sharon D Mattsson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346362019 PECOS PAC ID: 7315119419 Enrollment ID: I20111014000291 |
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