Provider Demographics
NPI:1205441243
Name:ACORN TO OAK WELLNESS STUDIO, LCSW, PLLC
Entity type:Organization
Organization Name:ACORN TO OAK WELLNESS STUDIO, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MED; LCSW
Authorized Official - Phone:860-318-1158
Mailing Address - Street 1:70 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1614
Mailing Address - Country:US
Mailing Address - Phone:860-318-1158
Mailing Address - Fax:
Practice Address - Street 1:70 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1614
Practice Address - Country:US
Practice Address - Phone:860-318-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty