Five Towns Community Center Coda Program

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

FIVE TOWNS COMMUNITY CENTER CODA PROGRAM

Practice address

270 Lawrence Ave
Coda Program
Lawrence, NY 11559-1224

Phone

(516) 239-6244

Fax

(516) 371-2147

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Lorenzo Sistrunk, M.A.

Title

Executive Director

Phone

(516) 239-6244

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

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

• Charlemagne Benjamin, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • Lawrence, NY
  • NPI 1114383064
  NPD (past)
• Danielle Feihel, LCSW

  • Clinical Social Worker
  • Lawrence, NY
  • NPI 1952632382
  NPD (past)
• Sharon Hall-Frey, LMSW

  • Social Worker
  • Lawrence, NY
  • NPI 1689356883
  NPD (past)
• Jose L. Melendez, C.A.S.A.C.

  • Addiction (Substance Use Disorder) Counselor
  • Lawrence, NY
  • NPI 1467783829
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1235256256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 LAWRENCE AVE",
            "address_2": "CODA PROGRAM",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591224",
            "telephone_number": "516-239-6244",
            "fax_number": "516-371-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 LAWRENCE AVE",
            "address_2": "CODA PROGRAM",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591224",
            "telephone_number": "516-239-6244",
            "fax_number": "516-371-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE TOWNS COMMUNITY CENTER CODA PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "SISTRUNK",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-239-6244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02784169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family First Staffing LLC
• Danielle Feihel, LCSW
• Leonard Feiner, MD
• Jonathon Marc Feintuch, LMSW
• Damaris Evangelina Feliz-Ali
• Five Towns Total Medical Care, P.C.
• Linda Leatherwood Foran, LMFT
• Lisa Frankel-Weiss, CCC-SLP
• Adena Yocheved Friedman
• Chana Friedman, LCSW

• Substance Abuse Rehabilitation Facility in Lawrence, NY
• Providers in Lawrence, NY by specialty
• Substance Abuse Rehabilitation Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.