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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043441413 | NPPES |
| New York | MEDICAID | 00041878LI |
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