Provider Demographics
NPI:1326856840
Name:WELCH-DEGOSKI, AUTUMN EMILY (LMHC)
Entity type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:EMILY
Last Name:WELCH-DEGOSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:EMILY
Other - Last Name:DEGOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 MOE RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3808
Mailing Address - Country:US
Mailing Address - Phone:518-844-5967
Mailing Address - Fax:
Practice Address - Street 1:2215 BURDETT AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2466
Practice Address - Country:US
Practice Address - Phone:518-844-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health