NPIMap

Organization Active NPI

Sullivan County Public Health Services

  • Early Intervention Provider Agency
  • Liberty, NY
National Provider Identifier
1104972876
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
SULLIVAN COUNTY PUBLIC HEALTH SERVICES
Practice address
50 Community LN
Liberty, NY 12754-2851
Phone
(845) 292-5910
Fax
(845) 513-2276
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Ms. Jill Hubert-Simon, MS
Title
Deputy Director
Phone
(845) 292-5910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

50 Community LN
Liberty, NY 12754-2851

Mailing address

50 Community LN
PO Box 590
Liberty, NY 12754-2851
Phone (845) 292-5910

Other identifiers 1

IdentifierTypeStateIssuer
00472977MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Sullivan County Public Health Services7 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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1104972876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 COMMUNITY LN",
            "address_2": "PO BOX 590",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542851",
            "telephone_number": "845-292-5910",
            "fax_number": "845-513-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 COMMUNITY LN",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542851",
            "telephone_number": "845-292-5910",
            "fax_number": "845-513-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN COUNTY PUBLIC HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "HUBERT-SIMON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "845-292-5910",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00472977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.