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Individual
THERON ISON
Active
Individual
THERON ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17336
NY
1041C0700X
Clinical Social Worker
Primary
098569
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244019
—
NY
Enumeration date
05/06/2010
Last updated
11/07/2024
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