Provider Demographics
NPI:1003839366
Name:SCARSDALE EDGEMONT FAMILY COUNSELING SERVICE
Entity Type:Organization
Organization Name:SCARSDALE EDGEMONT FAMILY COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:ACSWR
Authorized Official - Phone:914-723-3281
Mailing Address - Street 1:14 HARWOOD CT
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4121
Mailing Address - Country:US
Mailing Address - Phone:914-723-3281
Mailing Address - Fax:914-725-6046
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:SUITE 405
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4121
Practice Address - Country:US
Practice Address - Phone:914-723-3281
Practice Address - Fax:914-725-6046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0087341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty