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Organization
COME TO THE TABLE COUNSELING LCSW
Active
Organization
COME TO THE TABLE COUNSELING LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA M PERUSSE LCSW-R (PSYCHOTHERAPIST/OWNER)
(315) 335-9727
Entity
Organization
Contact information
Practice address
40 MAIN ST LOWR, CAMDEN, NY 13316-1302
(315) 335-9727
Mailing address
4097 WILSON RD E, TABERG, NY 13471-2037
(315) 335-9727
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05560238
—
NY
Enumeration date
11/25/2020
Last updated
11/25/2020
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