Provider Demographics
NPI:1164706636
Name:SCHENECTADY CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SCHENECTADY CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SHEPPECK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:518-881-3980
Mailing Address - Street 1:108 EDUCATION DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-1238
Mailing Address - Country:US
Mailing Address - Phone:518-370-8100
Mailing Address - Fax:518-370-8173
Practice Address - Street 1:108 EDUCATION DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1238
Practice Address - Country:US
Practice Address - Phone:518-370-8100
Practice Address - Fax:518-370-8173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01406986Medicaid