Organization Active NPI

Ronald L. Kissick, CSW & Patricia a. Kissick, CSW, PLLC

  • Clinical Social Worker
  • Endwell, NY
National Provider Identifier
1316056450
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RONALD L. KISSICK, CSW & PATRICIA A. KISSICK, CSW, PLLC
Doing business as
Personal Resource Center
Practice address
3220 Pearl St
Endwell, NY 13760-5758
Phone
(607) 754-4520
Fax
(607) 754-4021
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald L Kissick, CSW
Title
Owner Partner
Phone
(607) 754-4520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3220 Pearl St
Endwell, NY 13760-5758

Mailing address

3220 Pearl St
Endwell, NY 13760-5758
Phone (607) 754-4520

Other names 1

  • Personal Resource Center Doing business as

National Provider Directory

National Provider Directory

Locations

3220 Pearl St
Endwell, NY 13760
Phone (607) 729-8410

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316056450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-754-4520",
            "fax_number": "607-754-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-754-4520",
            "fax_number": "607-754-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD L. KISSICK, CSW & PATRICIA A. KISSICK, CSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KISSICK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "607-754-4520",
        "authorized_official_credential": "CSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Resource Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Endwell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.