NPIMap

Organization Active NPI

Schuyler County Mental Health

  • Clinical Social Worker
  • Watkins Glen, NY
National Provider Identifier
1003869165
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SCHUYLER COUNTY MENTAL HEALTH
Practice address
106 S Perry St
Ste 4
Watkins Glen, NY 14891-1615
Phone
(607) 535-8282
Fax
(607) 535-8284
NPI assigned
May 18, 2006
Last updated
May 28, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SCHUYLER COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
M Shawn Rosno, LCSW-R
Title
Director of Community Services
Phone
(607) 535-8282

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

106 S Perry St
Ste 4
Watkins Glen, NY 14891-1615

Mailing address

106 S Perry St
Ste 4
Watkins Glen, NY 14891-1615
Phone (607) 535-8282

Other identifiers 3

IdentifierTypeStateIssuer
000159429OtherNYBLUE CROSS BLUE SHEILD
00357520MedicaidNY
01371457MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000207 NY Part B Supplier - Clinic/Group Practice 8527970177 Receives reassigned benefits from 5 practitioners
Practice locations: Watkins Glen, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Venkata S Satti4 organizations share this tax ID, including this one
Part of
Venkata S Satti

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 S Perry St
Watkins Glen, NY 14891
Phone (607) 535-8140

106 S Perry St
Ste 4
Watkins Glen, NY 14891
Phone (607) 535-8282

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1003869165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST",
            "address_2": "STE 4",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911615",
            "telephone_number": "607-535-8282",
            "fax_number": "607-535-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST",
            "address_2": "STE 4",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911615",
            "telephone_number": "607-535-8282",
            "fax_number": "607-535-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUYLER COUNTY MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHUYLER COUNTY",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "ROSNO",
        "authorized_official_first_name": "M SHAWN",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "607-535-8282",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "000159429",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357520",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01371457",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkins Glen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.