Healthcare Provider Details

I. General information

NPI: 1093681645
Provider Name (Legal Business Name): SUMMIT COUNSELING SERVICES, LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 BECKWITH RD
PINE CITY NY
14871-9741
US

IV. Provider business mailing address

481 BECKWITH RD
PINE CITY NY
14871-9741
US

V. Phone/Fax

Practice location:
  • Phone: 607-590-5828
  • Fax:
Mailing address:
  • Phone: 607-590-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHLOE SCHROEDER
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 607-590-5828