Organization
CENTRAL ADIRONDACK COUNSELING LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TACEY A SHANNON LCSWR (LCSWR)
(518) 307-9292
Entity
Organization
Contact information
Practice address
333 GLEN ST STE 100, GLENS FALLS, NY 12801-3578
(518) 307-9292
(518) 615-5801
Mailing address
60 MELDON CIR, QUEENSBURY, NY 12804-5857
(518) 307-9292
(518) 615-5801
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992101505
NPI
NY
Enumeration date
03/22/2021
Last updated
03/22/2021
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