NPIMap

Organization Active NPI

Finger Lakes Area Counseling and Recovery Agency, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Clifton Springs, NY
National Provider Identifier
1366434011
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
FINGER LAKES AREA COUNSELING AND RECOVERY AGENCY, INC.
Practice address
28 E Main St
Clifton Springs, NY 14432
Phone
(315) 462-9466
Fax
(315) 462-6400
NPI assigned
Aug 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Mr. Martin Teller, MA
Title
Executive Director
Phone
(315) 462-9466

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X NY Primary
Adult Mental Health Clinic/Center 261QM0850X 8481001A NY
Substance Abuse Rehabilitation Facility 324500000X 190312132 NY

Addresses

Primary practice location

28 E Main St
Clifton Springs, NY 14432

Mailing address

28 E Main St
Clifton Springs, NY 14432-1231
Phone (315) 462-9466

Other identifiers 5

IdentifierTypeStateIssuer
00590372MedicaidNY
P012003753OtherNYBCH INPT
103019AMOtherNYPFC
P014003753OtherNYBLUE CHOICE
FLOtherNYBS

Other names 1

  • Finger Lakes Addiction Counseling and Referral Agency Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181011001185 NY Part B Supplier - Clinic/Group Practice 1254683766 Receives reassigned benefits from 22 practitioners
Practice locations: Rochester, NY; Watkins Glen, NY; Penn Yan, NY; Newark, NY; Geneva, NY; Farmington, NY; Clifton Springs, 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
33D2153833Finger Lakes Area Counseling and Recovery28 E Main Street, Clifton Springs, NY 14432Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

28 E Main St
Clifton Springs, NY 14432
Phone (315) 462-9466

1386 Hathaway Dr
#A
Farmington, NY 14425
Phone (315) 462-9466

116 Lewis St
Geneva, NY 14456
Phone (315) 781-0771

246 Castle St
Geneva, NY 14456
Phone 3157810771 ext. 309

310 W Union St
Newark, NY 14513
Phone (315) 331-3862

2466 Route 54A
Ste 300
Penn Yan, NY 14527
Phone (315) 536-7751

339 East Ave
Ste 303
Rochester, NY 14604
Phone (315) 462-9466

106 S Perry St
Ste 3
Watkins Glen, NY 14891
Phone (607) 535-8260

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1366434011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 E MAIN ST",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321231",
            "telephone_number": "315-462-9466",
            "fax_number": "315-462-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E MAIN ST",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "14432",
            "telephone_number": "315-462-9466",
            "fax_number": "315-462-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FINGER LAKES AREA COUNSELING AND RECOVERY AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "TELLER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-462-9466",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "8481001A",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "190312132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00590372",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCH INPT",
            "identifier": "P012003753",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFC",
            "identifier": "103019AM",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P014003753",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "FL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Finger Lakes Addiction Counseling and Referral Agency",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Finger Lakes Addiction Counseling and Referral Agency",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Clifton Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.