| Roots Counseling | |
|
24 E Main St Corfu NY 14036-9601 | |
| (585) 813-4075 | |
| Not Available |
| Full Name | Roots Counseling |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 24 E Main St, Corfu, New York |
| Authorized Official Name and Position | Valerie-lynn A Mutka (BUSINESS OWNER) |
| Authorized Official Contact | 5858134075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Counseling Po Box 57 Corfu NY 14036-0057 Ph: (585) 813-4075 | Roots Counseling 24 E Main St Corfu NY 14036-9601 Ph: (585) 813-4075 |
| NPI Number | 1285253922 |
|---|---|
| Provider Enumeration Date | 04/13/2020 |
| Last Update Date | 04/13/2020 |
| Certification Date | 04/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285253922 | NPI | - | NPPES |
| 1962596718 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |