Provider Demographics
NPI:1467580324
Name:COUNTY OF SCHENECTADY
Entity Type:Organization
Organization Name:COUNTY OF SCHENECTADY
Other - Org Name:SCPHS-CWSN
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPUTY COMMISSIONER PUBLIC HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CALLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-386-2810
Mailing Address - Street 1:107 NOTT TER
Mailing Address - Street 2:SUITE302
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3170
Mailing Address - Country:US
Mailing Address - Phone:518-386-2815
Mailing Address - Fax:518-386-2801
Practice Address - Street 1:107 NOTT TER
Practice Address - Street 2:SUITE302
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3170
Practice Address - Country:US
Practice Address - Phone:518-386-2815
Practice Address - Fax:518-386-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01219378Medicaid