Provider Demographics
NPI:1336416825
Name:BREWSTER CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BREWSTER CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:HENRIETTA
Authorized Official - Middle Name:W
Authorized Official - Last Name:LODGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-279-5051
Mailing Address - Street 1:50 FOGGINTOWN RD
Mailing Address - Street 2:BREWSTER HIGH SCHOOL
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2715
Mailing Address - Country:US
Mailing Address - Phone:845-279-5051
Mailing Address - Fax:845-279-8039
Practice Address - Street 1:50 FOGGINTOWN RD
Practice Address - Street 2:BREWSTER HIGH SCHOOL
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2715
Practice Address - Country:US
Practice Address - Phone:845-279-5051
Practice Address - Fax:845-279-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR025620-1251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)