Provider Demographics
NPI:1639194756
Name:MCCABE, ROSS B (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:B
Last Name:MCCABE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 RIVER ST STE 107
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-9695
Mailing Address - Country:US
Mailing Address - Phone:151-875-8779
Mailing Address - Fax:
Practice Address - Street 1:1301 RIVER ST STE 107
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-9695
Practice Address - Country:US
Practice Address - Phone:151-875-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN14531Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER