Provider Demographics
NPI:1629051149
Name:SPECTRUM BEHAVIORAL MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:SPECTRUM BEHAVIORAL MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:YOGESH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHINGALA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:845-485-3500
Mailing Address - Street 1:20 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2408
Mailing Address - Country:US
Mailing Address - Phone:845-485-3500
Mailing Address - Fax:845-485-8780
Practice Address - Street 1:510 HAIGHT AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2464
Practice Address - Country:US
Practice Address - Phone:845-485-3500
Practice Address - Fax:845-485-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW34571Medicare ID - Type Unspecified
NYW34563Medicare ID - Type Unspecified
NYW34562Medicare ID - Type Unspecified