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Organization
JILL VAN PELT LCSW PLLC
Active
Organization
JILL VAN PELT LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL A MESKUNAS-VAN PELT (CLINICAL SOCIAL WORKER)
(607) 595-9120
Entity
Organization
Contact information
Practice address
4513 OLD VESTAL RD, VESTAL, NY 13850-3571
(607) 729-7001
(607) 729-6434
Mailing address
29 DOWNS AVE, BINGHAMTON, NY 13905-1822
(607) 595-9120
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R069978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03115804
—
NY
Enumeration date
06/16/2014
Last updated
06/16/2014
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