| Mountain Community Wellness Center | |
|
210 Court St Suite 4 Watertown NY 13601-4546 | |
| (315) 221-4381 | |
| (315) 221-4382 |
| Full Name | Mountain Community Wellness Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 210 Court St, Watertown, New York |
| Authorized Official Name and Position | Jerry Michael Brown (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3152214381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Community Wellness Center 210 Court St Suite 4 Watertown NY 13601-4546 Ph: (315) 221-4381 | Mountain Community Wellness Center 210 Court St Suite 4 Watertown NY 13601-4546 Ph: (315) 221-4381 |
| NPI Number | 1619248762 |
|---|---|
| Provider Enumeration Date | 01/21/2012 |
| Last Update Date | 01/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619248762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 061925 (New York) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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