Doctor Name: | JUSTIN K THALHEIMER |
NPI Number: | 1073569299 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 077877-1 |
Business Practice Address: | 242 Main St Oneonta, NY - 138202527 |
Business Phone Number: | 6074311030 |
Business Fax Number: | |
Mailing Address: | Po Box 102, CHERRY VALLEY |
State: | NY |
Postal Code: | 133200102 |
Phone Number: | 5187052881 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 077877-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |