| Upstate Counseling, Licensed Clinical Social Work, Pllc | |
|
18 Computer Dr W Ste 102 Albany NY 12205-1616 | |
| (518) 517-4535 | |
| Not Available |
| Full Name | Upstate Counseling, Licensed Clinical Social Work, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 18 Computer Dr W Ste 102, Albany, New York |
| Authorized Official Name and Position | Douglas Roest-gyimah (OWNER) |
| Authorized Official Contact | 5185174535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Counseling, Licensed Clinical Social Work, Pllc 146 Kent St Albany NY 12206-2107 Ph: () - | Upstate Counseling, Licensed Clinical Social Work, Pllc 18 Computer Dr W Ste 102 Albany NY 12205-1616 Ph: (518) 517-4535 |
| NPI Number | 1548891484 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548891484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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