Individual
PHILBERT WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
177 EAST 122ND STREET, NEW YORK, NY 10035
(212) 360-7116
(212) 829-5156
Mailing address
3422 KNOX PLACE, APT. 2B, BRONX, NY 10467
(718) 881-3905
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17361
NY
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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