NPIMap

Organization Active NPI

Catholic Charities of Orange, Sullivan & Ulster

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Goshen, NY
National Provider Identifier
1093875007
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CATHOLIC CHARITIES OF ORANGE, SULLIVAN & ULSTER
Practice address
27 Matthews Street
Goshen, NY 10924
Phone
(845) 294-5124
Fax
(845) 294-1369
NPI assigned
Dec 11, 2006
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Shannon Kelly
Title
Chief Executive Officer
Phone
(845) 294-5124

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 070111579 NY
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

27 Matthews Street
Goshen, NY 10924

Mailing address

27 Matthews Street
Goshen, NY 10924
Phone (845) 294-5124

Other practice location 1

396 Broadway
Monticello, NY 12701-1157
Phone (845) 794-8080

Other practice location 2

280 Broadway Lowr Level
Newburgh, NY 12550-5408
Phone (845) 562-8255

Other practice location 3

101 Carpenter Pl
Monroe, NY 10950-3592
Phone (845) 782-0295

Other practice location 4

150 Pike St
Port Jervis, NY 12771-1867
Phone (845) 856-6344

Other practice location 5

8 Scofield St
Walden, NY 12586-1710
Phone (845) 778-5628

Other practice location 6

305 North St
Middletown, NY 10940-4704
Phone (845) 343-7675

Other practice location 7

17 Hamilton Ave
Monticello, NY 12701-1319
Phone (845) 794-8080

Other identifiers 1

IdentifierTypeStateIssuer
02739311MedicaidNY

Other names 1

  • Catholic Charities Community Services of Orange County Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220808001124 NY Part B Supplier - Clinic/Group Practice 8628450673 Receives reassigned benefits from 2 practitioners
Practice locations: Goshen, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2212367Catholic Charities of Orange, Sullivan and27 Matthews St, Goshen, NY 10924Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of Orange Sullivan Ulster7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

224 Main St
Goshen, NY 10924
Phone (845) 294-5124

27 Matthews St
Goshen, NY 10924
Phone (845) 294-5124

305 North St
Middletown, NY 10940
Phone (845) 343-7675

101 Carpenter Pl
Monroe, NY 10950
Phone (845) 476-4261

17 Hamilton Ave
Monticello, NY 12701

280 Broadway
Lowr
Newburgh, NY 12550
Phone (845) 562-2855

Practitioners & affiliated clinicians

Practitioners 129

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 129

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1093875007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MATTHEWS STREET",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-294-5124",
            "fax_number": "845-294-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MATTHEWS STREET",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-294-5124",
            "fax_number": "845-294-1369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "396 Broadway",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127011157",
            "country_code": "US",
            "telephone_number": "845-794-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Broadway Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125505408",
            "country_code": "US",
            "telephone_number": "845-562-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Carpenter Pl",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NY",
            "postal_code": "109503592",
            "country_code": "US",
            "telephone_number": "845-782-0295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Pike St",
            "address_purpose": "LOCATION",
            "city": "Port Jervis",
            "state": "NY",
            "postal_code": "127711867",
            "country_code": "US",
            "telephone_number": "845-856-6344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Scofield St",
            "address_purpose": "LOCATION",
            "city": "Walden",
            "state": "NY",
            "postal_code": "125861710",
            "country_code": "US",
            "telephone_number": "845-778-5628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 North St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109404704",
            "country_code": "US",
            "telephone_number": "845-343-7675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Hamilton Ave",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127011319",
            "country_code": "US",
            "telephone_number": "845-794-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF ORANGE, SULLIVAN & ULSTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "845-294-5124"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "070111579",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02739311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Charities Community Services of Orange County",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.