Provider Demographics
NPI:1073832952
Name:FINCH, SHELLEY A (CASAC)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:A
Last Name:FINCH
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-2332
Mailing Address - Country:US
Mailing Address - Phone:607-723-7308
Mailing Address - Fax:607-724-4626
Practice Address - Street 1:30 W STATE ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-2332
Practice Address - Country:US
Practice Address - Phone:607-723-7308
Practice Address - Fax:607-724-4626
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17667101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)