| Colonie Counseling Services, Lcsw, Pllc | |
|
1707 Central Ave Albany NY 12205 | |
| (518) 464-0232 | |
| (518) 464-0202 |
| Full Name | Colonie Counseling Services, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1707 Central Ave, Albany, New York |
| Authorized Official Name and Position | Sharon R. Polovina (OWNER) |
| Authorized Official Contact | 5184640232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonie Counseling Services, Lcsw, Pllc 1707 Central Ave. Albany NY 12205 Ph: (518) 464-0232 | Colonie Counseling Services, Lcsw, Pllc 1707 Central Ave Albany NY 12205 Ph: (518) 464-0232 |
| NPI Number | 1164768297 |
|---|---|
| Provider Enumeration Date | 12/18/2012 |
| Last Update Date | 05/18/2016 |
| Medicare PECOS PAC ID | 7517256159 |
|---|---|
| Medicare Enrollment ID | O20160520000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164768297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sharon R. Polovina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619041100 PECOS PAC ID: 4880628890 Enrollment ID: I20050920000495 |
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