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General NPI Number Information
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NPI Number | 1255119830
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Entity Type | Organization
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Legal Business Name | INSIGHT TO CLINICAL THERAPY LCSW PLLC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 600 OSWEGO ST
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City | LIVERPOOL
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State | NY
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Zip | 13088-5178
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Country | US
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Telephone | 315-658-6496
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Fax | 315-457-6000
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Provider Business Mailing Address
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Address Line | 600 OSWEGO ST
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City | LIVERPOOL
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State | NY
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Zip | 13088-5178
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Country | US
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Telephone | 315-760-4589
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Fax | 315-457-6000
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Authorized Official
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Title or Position | OWNER
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Name | RITA WORLOCK
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Credential | LCSW
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Telephone | 315-658-6496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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