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General NPI Number Information
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NPI Number | 1972013084
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING SERVICES, INC
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 5700 W GENESEE ST STE 118
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City | CAMILLUS
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State | NY
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Zip | 13031-3217
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Country | US
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Telephone | 315-488-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 W GENESEE ST STE 118
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City | CAMILLUS
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State | NY
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Zip | 13031-3218
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Country | US
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Telephone | 315-488-1641
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. KRISTIN W BOTWINICK
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Credential | LCSW-R
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Telephone | 315-466-6573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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