Provider Demographics
NPI:1053463828
Name:WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH
Entity Type:Organization
Organization Name:WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH
Other - Org Name:MT. KISCO COMMUNITY SERVICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CENTER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FEMINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-864-7101
Mailing Address - Street 1:25 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3112
Mailing Address - Country:US
Mailing Address - Phone:914-864-7101
Mailing Address - Fax:914-864-7121
Practice Address - Street 1:25 MOORE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3112
Practice Address - Country:US
Practice Address - Phone:914-864-7101
Practice Address - Fax:914-864-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044338-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty