Individual provider · Type 1 NPI

Jessica Detor, LMSW

Clinical Social Worker · Syracuse, NY

NPI number 1164989505 Active

Practice location

4900 Broad Rd, Physician Office Building North 3N
Syracuse, NY 13215-2265

Call (315) 949-1031 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X068827 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1164989505

Jessica Detor, LMSW's National Provider Identifier is 1164989505, issued on Feb 21, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Syracuse, NY. The record was last updated on Feb 21, 2019.