| Legacy Lcsw Counseling Services Pc | |
|
1541 Union St Schenectady NY 12309-6001 | |
| (518) 364-6632 | |
| (518) 565-0533 |
| Full Name | Legacy Lcsw Counseling Services Pc |
|---|---|
| Speciality | Social Worker |
| Location | 1541 Union St, Schenectady, New York |
| Authorized Official Name and Position | Sherman S Stovall (OWNER) |
| Authorized Official Contact | 5183646632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Lcsw Counseling Services Pc 132 Garnett Ln Slingerlands NY 12159-9538 Ph: (518) 364-6632 | Legacy Lcsw Counseling Services Pc 1541 Union St Schenectady NY 12309-6001 Ph: (518) 364-6632 |
| NPI Number | 1396080339 |
|---|---|
| Provider Enumeration Date | 12/03/2012 |
| Last Update Date | 12/03/2012 |
| Medicare PECOS PAC ID | 5193966166 |
|---|---|
| Medicare Enrollment ID | O20130802000610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396080339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 078968 (New York) | Primary |
| Provider Name | Johnna L Hawes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295861169 PECOS PAC ID: 4385735646 Enrollment ID: I20070801000470 |
| Provider Name | Sherman Stovall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669771812 PECOS PAC ID: 0749423143 Enrollment ID: I20130906000661 |
| Provider Name | Monica D'agostino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154602027 PECOS PAC ID: 5799915401 Enrollment ID: I20140225001392 |
| Provider Name | Peggy L Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245536788 PECOS PAC ID: 6204196892 Enrollment ID: I20191218000473 |
| Provider Name | Carla Natale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922568047 PECOS PAC ID: 7719314657 Enrollment ID: I20200305001053 |
| Provider Name | Amanda Student |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245796580 PECOS PAC ID: 9234566977 Enrollment ID: I20210115001663 |
| Provider Name | Katelyn Brunet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356771521 PECOS PAC ID: 1254745425 Enrollment ID: I20210129000122 |
| Provider Name | Cesar E Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659565000 PECOS PAC ID: 3779821657 Enrollment ID: I20220103000959 |
| Provider Name | Jennifer Colleen Merritt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013174390 PECOS PAC ID: 0345636213 Enrollment ID: I20220331002004 |
| Provider Name | Sharon L Keenan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750826152 PECOS PAC ID: 4688058498 Enrollment ID: I20220829000823 |
| Provider Name | Sally A Dalessandro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205303468 PECOS PAC ID: 0244680312 Enrollment ID: I20240102002691 |
| Provider Name | Melanie D Gilmore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720235880 PECOS PAC ID: 1759731730 Enrollment ID: I20240103002683 |
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