Essentia Telehealth Wellness, Lcsw, Pllc
NPI #1184459448 in Fayetteville, New York
Provider Information
- NPI Number
- 1184459448
- Entity Type
- Organization
- Organization Name
- Essentia Telehealth Wellness, Lcsw, Pllc
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Sep 5, 2024
- Last Updated
- Sep 5, 2024
Practice Location
- Address
- 110 MECHANIC ST
- City
- Fayetteville
- State
- New York
- ZIP Code
- 13066-1333
- Phone
- (505) 365-1519
Authorized Official
- Name
- ENRIQUE ANTONIO ROSARIO, LCSW-R
- Title
- CO-OWNER
- Phone
- (505) 365-1519
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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