Organization Active NPI

CG&D Alcoholism and Addiction Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Amityville, NY
National Provider Identifier
1508930694
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
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

Updated by the provider on Feb 26, 2008

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)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
338178OtherVALUE OPTIONS
02153551MedicaidNY

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.