Organization
DA MANCUSO COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A MANCUSO LCSW (OWNER)
(315) 735-8913
Entity
Organization
Contact information
Practice address
1402 GENESEE ST, UTICA, NY 13502-4727
(315) 735-8913
Mailing address
PO BOX 8307, UTICA, NY 13505-8307
(315) 735-8913
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01528427
—
NY
Enumeration date
01/17/2007
Last updated
08/22/2020
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