| Nine Skies Psychotherapy Lcsw, Pllc | |
|
4317 E Genesee St Syracuse NY 13214-2114 | |
| (315) 313-5564 | |
| Not Available |
| Full Name | Nine Skies Psychotherapy Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4317 E Genesee St, Syracuse, New York |
| Authorized Official Name and Position | Gary Paul Weinstein (OWNER) |
| Authorized Official Contact | 3155582645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nine Skies Psychotherapy Lcsw, Pllc 112 Dewittshire Rd Syracuse NY 13214-2209 Ph: (315) 558-2645 | Nine Skies Psychotherapy Lcsw, Pllc 4317 E Genesee St Syracuse NY 13214-2114 Ph: (315) 313-5564 |
| NPI Number | 1669218814 |
|---|---|
| Provider Enumeration Date | 07/08/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 5294273181 |
|---|---|
| Medicare Enrollment ID | O20240809001539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669218814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gary P. Weinstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922323898 PECOS PAC ID: 8820114770 Enrollment ID: I20100928001112 |
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