Provider Demographics
NPI:1972748853
Name:THE CHILD DEVELOPMENT COUNCIL
Entity Type:Organization
Organization Name:THE CHILD DEVELOPMENT COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-723-8313
Mailing Address - Street 1:24 CHERRY STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-0997
Mailing Address - Country:US
Mailing Address - Phone:607-723-8313
Mailing Address - Fax:607-723-6173
Practice Address - Street 1:24 CHERRY ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2615
Practice Address - Country:US
Practice Address - Phone:607-723-8313
Practice Address - Fax:607-723-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011716-1252Y00000X
NY004713-1252Y00000X
NY006460-1252Y00000X
NY017817-1252Y00000X
NY018450-1252Y00000X
NY006897-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency