| Avenues Counseling Ctr | |
|
402 N Cayuga St Ithaca NY 14850 | |
| (607) 272-7720 | |
| (607) 564-0554 |
| Full Name | Avenues Counseling Ctr |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 402 N Cayuga St, Ithaca, New York |
| Authorized Official Name and Position | Ellen C Peterson (OWNER PSYCHOTHERAPIST) |
| Authorized Official Contact | 6072727720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenues Counseling Ctr 402 N Cayuga St Ithaca NY 14850 Ph: (607) 272-7720 | Avenues Counseling Ctr 402 N Cayuga St Ithaca NY 14850 Ph: (607) 272-7720 |
| NPI Number | 1265646590 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 06/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265646590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | PR0432461 (New York) | Primary |
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