MEDICARE: POSITIVELY PSYCHED COUNSELING LCSW PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1962335521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVELY PSYCHED COUNSELING LCSW PLLC

Provider Business Mailing Address
First Line	:	320 W CENTER ST
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14901-1315
Country	:	US
Telephone Number	:	607-483-5366
Fax Number	:	607-558-2433

Provider Business Practice Location Address
First Line	:	320 W CENTER ST
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14901-1315
Country	:	US
Telephone Number	:	607-483-5366
Fax Number	:	607-558-2433

Authorized Official
Title or Position	:	OWNER
Name	:	DEBRA THATCHER
Credential	:	LCSW-R
Telephone Number	:	607-483-5366

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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