Healthcare Provider Details

I. General information

NPI: 1083295372
Provider Name (Legal Business Name): NEW HEIGHTS LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROUTE 146 STE 485
CLIFTON PARK NY
12065-3910
US

IV. Provider business mailing address

4 WYNDON RD
BALLSTON LAKE NY
12019-2527
US

V. Phone/Fax

Practice location:
  • Phone: 518-952-9206
  • Fax:
Mailing address:
  • Phone:
  • 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: BENJAMIN MCCORMACK
Title or Position: OWNER
Credential: LCSW
Phone: 518-952-9206