Healthcare Provider Details

I. General information

NPI: 1134133754
Provider Name (Legal Business Name): ADIRONDACK SOCIAL WORK SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 COREYS RD
TUPPER LAKE NY
12986
US

IV. Provider business mailing address

206 COREYS RD
TUPPER LAKE NY
12986
US

V. Phone/Fax

Practice location:
  • Phone: 518-359-2623
  • Fax: 518-359-8255
Mailing address:
  • Phone: 518-359-2623
  • Fax: 518-359-8255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number3437
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberR036992
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberR0376991
License Number StateNY

VIII. Authorized Official

Name: MR. KLAUS ERIC MEISSNER
Title or Position: THERAPIST COOWNER PARTNER
Credential: LCSW CASAC
Phone: 518-359-2623