Provider Demographics
NPI:1548479843
Name:MILISSA CERIO
Entity type:Organization
Organization Name:MILISSA CERIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILISSA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CERIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:607-737-4040
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2901
Mailing Address - Country:US
Mailing Address - Phone:607-737-4040
Mailing Address - Fax:607-734-0774
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2901
Practice Address - Country:US
Practice Address - Phone:607-737-4040
Practice Address - Fax:607-734-0774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty