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Organization
CIRCELLI LCSW SUPPORT SERVICES, PLLC
Active
Organization
CIRCELLI LCSW SUPPORT SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL R CIRCELLI LCSW-R (CLINICAL SOCIAL WORKER)
(315) 725-0461
Entity
Organization
Contact information
Practice address
12 OVERBROOK CIR, NEW HARTFORD, NY 13413-2349
(315) 725-0461
Mailing address
12 OVERBROOK CIR, NEW HARTFORD, NY 13413-2349
(315) 725-0461
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R080087-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R080087-1
LICENSED CLINICAL SOCIAL WORKER
NY
Enumeration date
06/18/2018
Last updated
11/13/2019
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