Provider Demographics
NPI:1689222390
Name:TOMPKINS COUNTY MENTAL HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:TOMPKINS COUNTY MENTAL HEALTH ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-273-9250
Mailing Address - Street 1:301 S GENEVA ST STE 109
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5443
Mailing Address - Country:US
Mailing Address - Phone:607-273-9250
Mailing Address - Fax:
Practice Address - Street 1:301 S GENEVA ST STE 109
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5443
Practice Address - Country:US
Practice Address - Phone:607-273-9250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health