Active NPI
CG&D Alcoholism and Addiction Services, Inc.
- Addiction (Substance Use Disorder) Counselor
- Amityville, NY
National Provider Identifier
1508930694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Legal business name
- CG&D ALCOHOLISM AND ADDICTION SERVICES, INC.
- Practice address
- 45 Dixon Ave
Amityville, NY 11701-2809 - Phone
- (631) 691-0769
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Theresa G Cooper
- Title
- Program Director, Casac, LPC
- Phone
- (631) 691-0769
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
45 Dixon Ave
Amityville, NY 11701-2809
Mailing address
45 Dixon Ave
Amityville, NY 11701-2809
Phone (631) 691-0769
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 338178 | Other | VALUE OPTIONS | |
| 02153551 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
45 Dixon Ave
Amityville, NY 11701
Phone (631) 691-0769
166 Broadway
Amityville, NY 11701
Phone (631) 574-4606
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Amityville, NY
- NPI 1306941729
-
- Clinical Social Worker
- Amityville, NY
- NPI 1861656373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203984000000",
"number": "1508930694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 DIXON AVE",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012809",
"telephone_number": "631-691-0769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 DIXON AVE",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012809",
"telephone_number": "631-691-0769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CG&D ALCOHOLISM AND ADDICTION SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-20",
"last_updated": "2008-02-26",
"status": "A",
"authorized_official_last_name": "COOPER",
"authorized_official_first_name": "THERESA",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PROGRAM DIRECTOR, CASAC, LPC",
"authorized_official_telephone_number": "631-691-0769",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "338178",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02153551",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.