| NPI | 1548891484 |
|---|---|
| Former Legal Business Name | UPSTATE COUNSELING, LICENSED CLINICAL SOCIAL WORK, PLLC |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROEST-GYIMAH Owner 518-517-4535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2025-03-17 |