Broken Walls Crushed Sidewalks Counseling LCSW PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BROKEN WALLS CRUSHED SIDEWALKS COUNSELING LCSW PC

Practice address

17 Avery Rd
Brushton, NY 12916-3400

Phone

(518) 353-3035

NPI assigned

Jun 21, 2017

Last updated

Feb 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Penny McQuinn, LCSWNPI 1659798197

Title

President

Phone

(518) 353-3035

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Penny McQuinn, LCSW

  • Social Worker
  • Brushton, NY
  • NPI 1659798197
  NPD (past) Authorized official

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1023538006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WEST ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531120",
            "telephone_number": "518-353-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 AVERY RD",
            "city": "BRUSHTON",
            "state": "NY",
            "postal_code": "129163400",
            "telephone_number": "518-353-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN WALLS CRUSHED SIDEWALKS COUNSELING LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "MCQUINN",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-353-3035",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rae Aubrey
• Nancy Boyer, TEACHER OF THE SPEEC
• Brushton-Moira Central School
• Joanne Cassavaw
• Stacie L Collette, RN
• Stephanie Maneely, RN
• Pamela M Martin, RN

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brushton, NY
• Providers in Brushton, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.