Provider Demographics
NPI:1003901695
Name:NORTHEAST PARENT AND CHILD SOCIETY, INC.
Entity Type:Organization
Organization Name:NORTHEAST PARENT AND CHILD SOCIETY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF BEHAVIORAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:518-381-8911
Mailing Address - Street 1:530 FRANKLIN ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2011
Mailing Address - Country:US
Mailing Address - Phone:518-381-8911
Mailing Address - Fax:518-377-4292
Practice Address - Street 1:530 FRANKLIN ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2011
Practice Address - Country:US
Practice Address - Phone:518-381-8911
Practice Address - Fax:518-377-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02664359Medicaid