Provider Demographics
NPI:1396882635
Name:COUNSELING SERVICE OF THE EPISCOPAL DIOCESE OF ALBANY, INC
Entity type:Organization
Organization Name:COUNSELING SERVICE OF THE EPISCOPAL DIOCESE OF ALBANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MINUCCI
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-465-8728
Mailing Address - Street 1:116 S LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3371
Mailing Address - Country:US
Mailing Address - Phone:518-465-8728
Mailing Address - Fax:518-436-3576
Practice Address - Street 1:116 S LAKE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3371
Practice Address - Country:US
Practice Address - Phone:518-465-8728
Practice Address - Fax:518-436-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY54324AMedicare ID - Type UnspecifiedGROUP MEDICARE ID