Provider Demographics
NPI:1851514178
Name:DAVIS AND NEZELEK CLINICAL COUNSELING
Entity Type:Organization
Organization Name:DAVIS AND NEZELEK CLINICAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.C.S.W.
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NEZELEK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:607-563-4080
Mailing Address - Street 1:76 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1112
Mailing Address - Country:US
Mailing Address - Phone:607-563-4080
Mailing Address - Fax:
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1112
Practice Address - Country:US
Practice Address - Phone:607-563-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty