Organization
CRYSTAL WATERS LICENSED CLINICAL SOCIAL WORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET L FABIAN LCSWR (OWNER)
(607) 654-9872
Entity
Organization
Contact information
Practice address
83 W PULTENEY ST, CORNING, NY 14830-2213
(607) 654-9872
(607) 973-2727
Mailing address
62 SOUTH ST, ADDISON, NY 14801-1319
(607) 654-9872
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
080623
NY
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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