Provider Demographics
NPI:1043435597
Name:SARATOGA STRESS REDUCTION PROGRAM
Entity Type:Organization
Organization Name:SARATOGA STRESS REDUCTION PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:RAE RUSSELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:518-857-9361
Mailing Address - Street 1:58 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-3232
Mailing Address - Country:US
Mailing Address - Phone:518-581-3180
Mailing Address - Fax:518-581-3182
Practice Address - Street 1:58 HENRY ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-3232
Practice Address - Country:US
Practice Address - Phone:518-581-3180
Practice Address - Fax:518-581-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014405-1103T00000X
NY070617-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty