Provider Demographics
NPI:1033276662
Name:COUNTY OF NASSAU COUNTY CONTROLLER
Entity Type:Organization
Organization Name:COUNTY OF NASSAU COUNTY CONTROLLER
Other - Org Name:NC OFFICE OF MENTAL HEALTH, CHEMICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STATISTICIAN/FISCAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALATYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-572-3298
Mailing Address - Street 1:2201 HEMPSTEAD TPKE BLDG K
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1859
Mailing Address - Country:US
Mailing Address - Phone:516-572-3298
Mailing Address - Fax:516-572-6777
Practice Address - Street 1:2201 HEMPSTEAD TPKE BLDG K
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:516-572-5906
Practice Address - Fax:516-572-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2957202R261QM0801X, 261QM2800X, 261QP2300X
NY2951202R261QM2800X, 261QP2300X, 261QR0405X
NY259-7202R261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00689730Medicaid