Provider Demographics
NPI:1245393115
Name:RECOVERY COUNSELING SERVICES
Entity Type:Organization
Organization Name:RECOVERY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NCAC II
Authorized Official - Phone:315-475-1771
Mailing Address - Street 1:109 S WARREN ST STE 508
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-4734
Mailing Address - Country:US
Mailing Address - Phone:315-475-1771
Mailing Address - Fax:315-475-4601
Practice Address - Street 1:109 S WARREN ST STE 508
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-4734
Practice Address - Country:US
Practice Address - Phone:315-475-1771
Practice Address - Fax:315-475-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16340101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01936565Medicaid