| Broken Walls Crushed Sidewalks Counseling Lcsw Pc | |
|
17 Avery Rd Brushton NY 12916-3400 | |
| (518) 353-3035 | |
| Not Available |
| Full Name | Broken Walls Crushed Sidewalks Counseling Lcsw Pc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 17 Avery Rd, Brushton, New York |
| Authorized Official Name and Position | Penny Mcquinn (PRESIDENT) |
| Authorized Official Contact | 5183533035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Walls Crushed Sidewalks Counseling Lcsw Pc 100 West St Malone NY 12953-1120 Ph: (518) 353-3035 | Broken Walls Crushed Sidewalks Counseling Lcsw Pc 17 Avery Rd Brushton NY 12916-3400 Ph: (518) 353-3035 |
| NPI Number | 1023538006 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 02/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023538006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |