Healthcare Provider Details

I. General information

NPI: 1114390952
Provider Name (Legal Business Name): RENEE COMSTOCK LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E GERMAN ST STE 3
HERKIMER NY
13350-1049
US

IV. Provider business mailing address

628 MARY ST
UTICA NY
13501-2419
US

V. Phone/Fax

Practice location:
  • Phone: 315-316-1533
  • Fax: 315-501-2646
Mailing address:
  • Phone: 315-272-2700
  • Fax: 315-732-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number096526
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: