NPIMap

Organization Active NPI

The Eden Center for Integrative Care

  • Psychologist
  • Glens Falls, NY
National Provider Identifier
1457027526
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
THE EDEN CENTER FOR INTEGRATIVE CARE
Practice address
84 Broad St
Glens Falls, NY 12801-4386
Phone
(518) 636-5284
NPI assigned
Aug 19, 2021
Last updated
Aug 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Chelsea Davis
Title
Office Manager
Phone
(518) 791-2856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

84 Broad St
Glens Falls, NY 12801-4386

Mailing address

84 Broad St Ste 2
Glens Falls, NY 12801-4381
Phone (518) 636-5284

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.theedencarecenter.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926003857 NY Part B Supplier - Clinic/Group Practice 0749634640 Receives reassigned benefits from 12 practitioners
Practice locations: Glens Falls, NY; Saratoga Springs, NY

National Provider Directory

National Provider Directory

Locations

84 Broad St
Ste 2
Glens Falls, NY 12801
Phone (518) 636-5284

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1457027526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 BROAD ST STE 2",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014381",
            "telephone_number": "518-636-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014386",
            "telephone_number": "518-636-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EDEN CENTER FOR INTEGRATIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-791-2856"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.theedencarecenter.com",
            "affiliation": "N",
            "address_1": "84 Broad St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.