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General NPI Number Information
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NPI Number | 1437227105
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Entity Type | Organization
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Legal Business Name | ELLIOT-BEARCE ASSOCIATES CSW PC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 409 MAPLE AVE
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-5502
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Country | US
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Telephone | 518-584-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 103 SQUASHVILLE RD
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City | GREENFIELD CENTER
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State | NY
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Zip | 12833-1012
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Country | US
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Telephone | 518-893-7438
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Fax | 518-893-7438
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MR. CHARLES G BEARCE
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Credential | LCSW
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Telephone | 518-893-7438
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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 | R030925-1
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License Number State | NY
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