| Organization Name: | RONALD L. KISSICK, CSW & PATRICIA A. KISSICK, CSW, PLLC |
| NPI Number: | 1316056450 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD L KISSICK (OWNER PARTNER) |
| Mailing Address: | 3220 Pearl St Endwell |
| State: | NY US |
| Postal Code: | 137605758 |
| Phone Number: | 6077544520 |
| Fax Number: | 6077544021 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |