1669679627 NPI number — SAMARITAN COUNSELING CENTER OF THE MOHAWK VALLEY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669679627 NPI number — SAMARITAN COUNSELING CENTER OF THE MOHAWK VALLEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMARITAN COUNSELING CENTER OF THE MOHAWK VALLEY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669679627
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 MEADOWBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HARTFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13413-3804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-735-2130
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1643 GENESEE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UTICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13501-4733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-724-5173
Provider Business Practice Location Address Fax Number:
315-724-5323
Provider Enumeration Date:
07/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARCURI
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
RESIDENT THERAPIST
Authorized Official Telephone Number:
315-724-5173

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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