NPIMap

Organization Active NPI

Warren Washington Association for Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hudson Falls, NY
National Provider Identifier
1073549796
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WARREN WASHINGTON ASSOCIATION FOR MENTAL HEALTH, INC
Practice address
3043 State Route 4
Hudson Falls, NY 12839-9632
Phone
(518) 747-2284
Fax
(518) 747-2253
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Authorized official

Name
Peter Groff
Title
Ceo
Phone
(518) 747-2284

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

3043 State Route 4
Hudson Falls, NY 12839-9632

Mailing address

3043 State Route 4
Hudson Falls, NY 12839-9632
Phone (518) 747-2284

Other identifiers 4

IdentifierTypeStateIssuer
01114832MedicaidNY
01305095MedicaidNY
01138352MedicaidNY
DF0629OtherMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061004000607 NY Part B Supplier - Clinic/Group Practice 5496751034 Receives reassigned benefits from 11 practitioners
Practice locations: Hudson Falls, NY

National Provider Directory

National Provider Directory

Locations

3043 State Route 4
Hudson Falls, NY 12839
Phone (518) 747-2284

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/10d65d12-0ecf-4613-84df-07c7c4f09ca4/

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1073549796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 STATE ROUTE 4",
            "city": "HUDSON FALLS",
            "state": "NY",
            "postal_code": "128399632",
            "telephone_number": "518-747-2284",
            "fax_number": "518-747-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 STATE ROUTE 4",
            "city": "HUDSON FALLS",
            "state": "NY",
            "postal_code": "128399632",
            "telephone_number": "518-747-2284",
            "fax_number": "518-747-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN WASHINGTON ASSOCIATION FOR MENTAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "518-747-2284"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01114832",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01305095",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01138352",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF0629",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.