| Breakwaters Mental Health Counseling Pllc | |
|
3043 State Route 13 Pulaski NY 13142-2429 | |
| (315) 440-6906 | |
| Not Available |
| Full Name | Breakwaters Mental Health Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3043 State Route 13, Pulaski, New York |
| Authorized Official Name and Position | Jessica Elizabeth Connors (OWNER) |
| Authorized Official Contact | 3154406906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakwaters Mental Health Counseling Pllc 3043 State Route 13 Pulaski NY 13142-2429 Ph: (315) 440-6906 | Breakwaters Mental Health Counseling Pllc 3043 State Route 13 Pulaski NY 13142-2429 Ph: (315) 440-6906 |
| NPI Number | 1073118469 |
|---|---|
| Provider Enumeration Date | 12/02/2020 |
| Last Update Date | 12/02/2020 |
| Certification Date | 12/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073118469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Angela L. Christmas-mattison Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Hubble St, Pulaski, NY 13142 Phone: 315-298-6535 Fax: 315-298-6535 |