Provider Demographics
NPI:1750179131
Name:BRICK BY BRICK WELLNESS LCSW PLLC
Entity type:Organization
Organization Name:BRICK BY BRICK WELLNESS LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:315-810-2191
Mailing Address - Street 1:304 WESTVALE RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1534
Mailing Address - Country:US
Mailing Address - Phone:315-810-2191
Mailing Address - Fax:
Practice Address - Street 1:528 OAK ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1643
Practice Address - Country:US
Practice Address - Phone:315-810-2191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty