Provider Demographics
NPI:1487351565
Name:BREAKTHROUGH COUNSELING, LCSW, PLLC
Entity type:Organization
Organization Name:BREAKTHROUGH COUNSELING, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:716-640-4418
Mailing Address - Street 1:515 PINE ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-5345
Mailing Address - Country:US
Mailing Address - Phone:716-201-0015
Mailing Address - Fax:
Practice Address - Street 1:515 PINE ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-5345
Practice Address - Country:US
Practice Address - Phone:716-201-0015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty