Organization
WELL CHILD LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA M RUGGIERO LCSW (MANAGING MEMBER)
(518) 480-4002
Entity
Organization
Contact information
Practice address
92 BROAD ST FL 2, GLENS FALLS, NY 12801-4383
(151) 822-2589
Mailing address
92 BROAD ST FL 2, GLENS FALLS, NY 12801-4383
(151) 822-2589
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598149395
NPPES
NY
Enumeration date
06/06/2022
Last updated
06/06/2022
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