Provider Demographics
NPI:1790222313
Name:CAPITAL DISTRICT BEGINNINGS
Entity Type:Organization
Organization Name:CAPITAL DISTRICT BEGINNINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:EVAYLN
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED
Authorized Official - Phone:518-854-2016
Mailing Address - Street 1:105 EAST BROADWAY
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:12865
Mailing Address - Country:US
Mailing Address - Phone:518-854-2016
Mailing Address - Fax:
Practice Address - Street 1:673 COLUMBIA TURNPIKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061
Practice Address - Country:US
Practice Address - Phone:518-233-0544
Practice Address - Fax:518-992-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17440000252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherSPECIAL EDUCATOR