NPIMap

Organization Active NPI

Southern Tier Counseling Center, LLC

  • Clinical Social Worker
  • Elmira, NY
National Provider Identifier
1598716292
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R060513-1 Issued in NY
Legal business name
SOUTHERN TIER COUNSELING CENTER, LLC
Practice address
407 W Water St
Elmira, NY 14905-2521
Phone
(607) 734-0980
Fax
(607) 734-0981
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Ms. Kathleen A Webster, LCSWRNPI 1205937778
Title
Owner
Phone
(607) 734-0980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X R060513-1 NY Primary

Addresses

Primary practice location

407 W Water St
Elmira, NY 14905-2521

Mailing address

407 W Water St
Elmira, NY 14905-2521
Phone (607) 734-0980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050204000091 NY Part B Supplier - Clinic/Group Practice 1658322805 Receives reassigned benefits from 6 practitioners
Practice locations: Elmira, NY

National Provider Directory

National Provider Directory

Locations

407 W Water St
Elmira, NY 14905
Phone (607) 734-0980

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1598716292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052521",
            "telephone_number": "607-734-0980",
            "fax_number": "607-734-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052521",
            "telephone_number": "607-734-0980",
            "fax_number": "607-734-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-734-0980",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSWR"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R060513-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.