| Jacob Studioso, Lcsw, Pllc | |
|
84 Avon Geneseo Rd Suite B Geneseo NY 14454 | |
| (585) 628-4200 | |
| Not Available |
| Full Name | Jacob Studioso, Lcsw, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 84 Avon Geneseo Rd, Geneseo, New York |
| Authorized Official Name and Position | Jacob Studioso (OWNER) |
| Authorized Official Contact | 5856284200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Studioso, Lcsw, Pllc Po Box 706 Geneseo NY 14454-0706 Ph: (585) 628-4200 | Jacob Studioso, Lcsw, Pllc 84 Avon Geneseo Rd Suite B Geneseo NY 14454 Ph: (585) 628-4200 |
| NPI Number | 1790421329 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 05/06/2022 |
| Certification Date | 04/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790421329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Tera L. Storms, Psy.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 150 Court St, Suite 1, Geneseo, NY 14454 Phone: 585-301-7483 Fax: 585-359-8055 | |
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