Provider Demographics
NPI:1679949317
Name:BETH A WALDO WINDSOR COUNSELING EAST
Entity Type:Organization
Organization Name:BETH A WALDO WINDSOR COUNSELING EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALDO
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:845-565-6888
Mailing Address - Street 1:555 BLOOMING GROVE TPKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7843
Mailing Address - Country:US
Mailing Address - Phone:845-565-6888
Mailing Address - Fax:845-565-0142
Practice Address - Street 1:555 BLOOMING GROVE TPKE
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7843
Practice Address - Country:US
Practice Address - Phone:845-565-6888
Practice Address - Fax:845-565-0142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH A WALDO WINDSOR COUNSELING EAST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0814931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty