Organization · Type 2 NPI

Professional Practice Group, Dept. of Psych

Clinical Social Worker · Syracuse, NY

NPI number 1710929047 Active

Practice location

750 E Adams St
Syracuse, NY 13210-2306

Call (315) 464-3119 Map

Fax (315) 464-3282

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist 103TC0700XNone listed
Clinical Social Worker Primary 1041C0700XNone listed
Psychiatry Physician 2084P0800XNone listed

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 1710929047

Professional Practice Group, Dept. of Psych's National Provider Identifier is 1710929047, issued on Jun 12, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Syracuse, NY. The record was last updated on Sep 11, 2025.