Provider Demographics
NPI:1225178445
Name:RECOVERY COUNSELING, LLC
Entity Type:Organization
Organization Name:RECOVERY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOUDYMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CASAC
Authorized Official - Phone:315-255-3559
Mailing Address - Street 1:188 GENESEE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3324
Mailing Address - Country:US
Mailing Address - Phone:315-255-3559
Mailing Address - Fax:315-255-3823
Practice Address - Street 1:188 GENESEE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3324
Practice Address - Country:US
Practice Address - Phone:315-255-3559
Practice Address - Fax:315-255-3823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY44290OtherBLUE CROSS EXCELLUS
NY02588416Medicaid
NY47830Medicaid