Provider Demographics
NPI:1659414696
Name:COUNTY OF CATTARAUGUS
Entity Type:Organization
Organization Name:COUNTY OF CATTARAUGUS
Other - Org Name:DEPT OF COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:716-373-8040
Mailing Address - Street 1:1 LEO MOSS DR
Mailing Address - Street 2:SUITE 4308
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1100
Mailing Address - Country:US
Mailing Address - Phone:716-373-8040
Mailing Address - Fax:716-373-4820
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:SUITE 4308
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1100
Practice Address - Country:US
Practice Address - Phone:716-373-8040
Practice Address - Fax:716-373-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000512061001OtherBCBS
NY00635098Medicaid
NY00030195301OtherUNIVERA
NY050519000045OtherFIDELIS
NY159844OtherVALUE OPTIONS
NY159844OtherVALUE OPTIONS