Provider Demographics
NPI:1861032575
Name:CHAUTAUQUA COUNTY MENTAL HYGIENE
Entity Type:Organization
Organization Name:CHAUTAUQUA COUNTY MENTAL HYGIENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILDREN'S SPOA
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VON HOF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:716-661-8857
Mailing Address - Street 1:2 ACADEMY ST RM 201
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14757-1050
Mailing Address - Country:US
Mailing Address - Phone:716-753-4104
Mailing Address - Fax:716-753-4230
Practice Address - Street 1:2 ACADEMY ST RM 201
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:14757-1050
Practice Address - Country:US
Practice Address - Phone:716-753-4104
Practice Address - Fax:716-753-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty