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Organization
COAST TO COAST LCSW PLLC
Active
Organization
COAST TO COAST LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE ANN TATOWICZ LCSW (OWNER)
(607) 319-3036
Entity
Organization
Contact information
Practice address
208 N MEADOW ST UNIT 2, ITHACA, NY 14850-4027
(607) 319-3036
Mailing address
PO BOX 4804, ITHACA, NY 14852-4804
(607) 319-3036
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487994570
PERSONAL NPI NUMBER
NY
Enumeration date
08/10/2022
Last updated
08/10/2022
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