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Organization
COPELAND COUNSELING FOR YOUTH
Active
Organization
COPELAND COUNSELING FOR YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN STAFFORD THOMAS LCSW-R (LICENSED CLINICAL SOCIAL WORKER)
(315) 243-1578
Entity
Organization
Contact information
Practice address
24 COPELAND AVE, HOMER, NY 13077-1529
(315) 243-1578
Mailing address
24 COPELAND AVE, HOMER, NY 13077-1529
(315) 243-1578
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R066704-1
NY
Other
Enumeration date
10/22/2006
Last updated
06/26/2008
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