Healthcare Provider Details

I. General information

NPI: 1003400169
Provider Name (Legal Business Name): TRISTEN E TURKOW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRISTEN E BUCKLEY LMSW

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST. STE A
CORTLAND NY
13045-3049
US

IV. Provider business mailing address

165 MAIN ST STE A
CORTLAND NY
13045-3191
US

V. Phone/Fax

Practice location:
  • Phone: 607-753-0234
  • Fax:
Mailing address:
  • Phone: 607-753-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103594
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: