Organization
BROKEN WALLS CRUSHED SIDEWALKS COUNSELING LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY MCQUINN LCSW (PRESIDENT)
(518) 353-3035
Entity
Organization
Contact information
Practice address
17 AVERY RD, BRUSHTON, NY 12916-3400
(518) 353-3035
Mailing address
100 WEST ST, MALONE, NY 12953-1120
(518) 353-3035
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/21/2017
Last updated
02/26/2018
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