Provider Demographics
NPI:1407132111
Name:CITY SCHOOL DISTRICT OF ALBANY
Entity Type:Organization
Organization Name:CITY SCHOOL DISTRICT OF ALBANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-462-7259
Mailing Address - Street 1:108 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1447
Mailing Address - Country:US
Mailing Address - Phone:518-462-7259
Mailing Address - Fax:518-462-7265
Practice Address - Street 1:108 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1447
Practice Address - Country:US
Practice Address - Phone:518-462-7259
Practice Address - Fax:518-462-7265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73040978251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)