Port Counseling Center Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PORT COUNSELING CENTER INC

Practice address

225 Main St
Port Washington, NY 11050-3211

Phone

(516) 767-1133

Fax

(516) 767-3680

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Agnes Lasetchuk, CSW

Title

Executive Director

Phone

(516) 767-1133

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215025366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503211",
            "telephone_number": "516-767-1133",
            "fax_number": "516-767-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503211",
            "telephone_number": "516-767-1133",
            "fax_number": "516-767-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LASETCHUK",
        "authorized_official_first_name": "AGNES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-767-1133",
        "authorized_official_credential": "CSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02760429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Port Washington, NY
• Providers in Port Washington, NY by specialty
• Community/Behavioral Health Agency in New York

• 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.