Provider Demographics
NPI:1649972423
Name:COMPASSIONATE CONNECTIONS COUPLES COUNSELING LCSW PLLC
Entity type:Organization
Organization Name:COMPASSIONATE CONNECTIONS COUPLES COUNSELING LCSW PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:607-220-9689
Mailing Address - Street 1:2680 SLATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SLATERVILLE SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14881-9412
Mailing Address - Country:US
Mailing Address - Phone:607-220-9689
Mailing Address - Fax:
Practice Address - Street 1:2680 SLATERVILLE RD
Practice Address - Street 2:
Practice Address - City:SLATERVILLE SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14881-9412
Practice Address - Country:US
Practice Address - Phone:607-220-9689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty