Individual provider Active NPI

Ferdinand S Haverly, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • East Greenbush, NY
National Provider Identifier
1073762050
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
743 Columbia Tpke
East Greenbush, NY 12061-2266
Phone
(518) 477-7535
NPI assigned
Sep 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

743 Columbia Tpke
East Greenbush, NY 12061-2266

Mailing address

743 Columbia Tpke
East Greenbush, NY 12061-2266
Phone (518) 477-7535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1073762050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 COLUMBIA TPKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612266",
            "telephone_number": "518-477-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 COLUMBIA TPKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612266",
            "telephone_number": "518-477-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLY",
        "first_name": "FERDINAND",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.