NPIMap

Organization Active NPI

Otsego County Community Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cooperstown, NY
National Provider Identifier
1467555243
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
061110917 Issued in NY
Legal business name
OTSEGO COUNTY COMMUNITY SERVICES
Practice address
140 County Highway 33W
Suite 1
Cooperstown, NY 13326-4953
Phone
(607) 547-1600
Fax
(607) 547-1607
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Ms. Susan A Matt, LCSW/CASAC
Title
Director of Community Services
Phone
(607) 433-2343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 061110917 NY Primary

Addresses

Primary practice location

140 County Highway 33W
Suite 1
Cooperstown, NY 13326-4953

Mailing address

242 Main St
Second Floor
Oneonta, NY 13820-2527
Phone (607) 431-1030

Other identifiers 1

IdentifierTypeStateIssuer
00583582MedicaidNY

Other names 1

  • Otsego County Chemical Dependencies Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ostego MNTL HLTH SVC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

140 County Highway 33W
Ste 1
Cooperstown, NY 13326
Phone (607) 547-1600

242 Main St
Ste 2
Oneonta, NY 13820
Phone (607) 431-1030

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1467555243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MAIN ST",
            "address_2": "SECOND FLOOR",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202527",
            "telephone_number": "607-431-1030",
            "fax_number": "607-431-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COUNTY HIGHWAY 33W",
            "address_2": "SUITE 1",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133264953",
            "telephone_number": "607-547-1600",
            "fax_number": "607-547-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTSEGO COUNTY COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "MATT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "607-433-2343",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW/CASAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "061110917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00583582",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otsego County Chemical Dependencies Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cooperstown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.