Berliss, Michelle

Berliss, Michelle 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. Berliss, Michelle 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 103TC0700X 015076 New York

Profile Details

NPI number 1629098983
LBN Legal business name Berliss, Michelle
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2007 - about 19 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 1629098983 NPPES
New York MEDICAID 06800015076LI

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