Healthcare Provider Details

I. General information

NPI: 1851574800
Provider Name (Legal Business Name): RONALD CHESTER SCHLEGEL MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 VETERANS AVE
BATH NY
14810-0810
US

IV. Provider business mailing address

659 COUNTY ROUTE 5
ADDISON NY
14801-9794
US

V. Phone/Fax

Practice location:
  • Phone: 607-664-4000
  • Fax:
Mailing address:
  • Phone: 607-359-3095
  • Fax: 607-359-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR029628-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: