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Organization
KOON COUNSELING SERVICES LMSW, P.C.
Active
Organization
KOON COUNSELING SERVICES LMSW, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KOON (OWNER)
(315) 430-4070
Entity
Organization
Contact information
Practice address
317 W 1ST ST STE 112, OSWEGO, NY 13126-3678
(315) 021-6068
Mailing address
208 EASTERLY TER, DE WITT, NY 13214-2316
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
0000000
—
Enumeration date
05/19/2017
Last updated
05/19/2017
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