Provider Demographics
NPI:1578769832
Name:COUNSELING FOR LAITY ROMAN CATHOLIC DIOCESE OF ALBANY NY
Entity Type:Organization
Organization Name:COUNSELING FOR LAITY ROMAN CATHOLIC DIOCESE OF ALBANY NY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR COUNSELING FOR L
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:SMOLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:518-453-6625
Mailing Address - Street 1:40 NORTH MAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1422
Mailing Address - Country:US
Mailing Address - Phone:518-453-6625
Mailing Address - Fax:518-453-6793
Practice Address - Street 1:40 NORTH MAIN AVENUE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1422
Practice Address - Country:US
Practice Address - Phone:518-453-6625
Practice Address - Fax:518-453-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
52563AMedicare ID - Type Unspecified