Organization
CULTIVATING GROWTH LICENSED CLINICAL SOCIAL WORK, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE L WILLIAMS LCSW (MEMBER)
(607) 280-0550
Entity
Organization
Contact information
Practice address
301 S GENEVA ST, ITHACA, NY 14850-5445
(607) 280-0550
Mailing address
PO BOX 722, ITHACA, NY 14851-0722
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
082085
NY
Other
Enumeration date
06/19/2017
Last updated
06/19/2017
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