Wentworth, Kerseinya Gretchen

Wentworth, Kerseinya Gretchen is an individual health care provider with primary practice located at 106 S Perry St Ste 4, Watkins Glen NY 14891-1615. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wentworth, Kerseinya Gretchen can be contacted via phone (607) 535-8282.

Contact Information

Primary practice address
106 S Perry St Ste 4 Watkins Glen NY 14891-1615
Phone: (607) 535-8282
Fax: (607) 535-8284
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 041878 New York

Profile Details

NPI number 1043441413
LBN Legal business name Wentworth, Kerseinya Gretchen
Credentials LCSWR
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2009
Last updated Aug 4th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043441413 NPPES
New York MEDICAID 00041878LI

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