Healthcare Provider Details

I. General information

NPI: 1487517033
Provider Name (Legal Business Name): PARLOR CITY WELLNESS, LCSW, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CASTLE CREEK RD
BINGHAMTON NY
13901-1005
US

IV. Provider business mailing address

3 BROOKSIDE RD
BINGHAMTON NY
13903-1415
US

V. Phone/Fax

Practice location:
  • Phone: 607-444-2850
  • Fax: 877-552-1301
Mailing address:
  • Phone: 607-280-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KROHN
Title or Position: LCSW/OWNER
Credential: LCSW
Phone: 607-444-2850