NPIMap

Organization Active NPI

Fulton County Addiction Services

  • Community/Behavioral Health Agency
  • Gloversville, NY
National Provider Identifier
1043387533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FULTON COUNTY ADDICTION SERVICES
Doing business as
Fulton County Mental Health Clinic
Practice address
73 N Main St
3Rd Floor Suite 302
Gloversville, NY 12078-3043
Phone
(518) 773-3532
Fax
(518) 773-4003
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ernest J Gagnon, LMSW
Title
Director of Community Services
Phone
(518) 773-3531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NY Primary

Addresses

Primary practice location

73 N Main St
3Rd Floor Suite 302
Gloversville, NY 12078-3043

Mailing address

73 N Main St
3Rd Floor Suite 302
Gloversville, NY 12078-3043
Phone (518) 773-3532

Other identifiers 1

IdentifierTypeStateIssuer
00562863MedicaidOK

Other names 1

  • Fulton County Mental Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fulton County Addiction Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

73 N Main St
Ste 302
Gloversville, NY 12078
Phone (518) 773-3532

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043387533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 N MAIN ST",
            "address_2": "3RD FLOOR SUITE 302",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783043",
            "telephone_number": "518-773-3532",
            "fax_number": "518-773-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 N MAIN ST",
            "address_2": "3RD FLOOR SUITE 302",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783043",
            "telephone_number": "518-773-3532",
            "fax_number": "518-773-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON COUNTY ADDICTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "518-773-3531",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00562863",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton County Mental Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gloversville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.