NPIMap

Organization Active NPI

Intensive Case Management Program

  • Case Management Agency
  • Brentwood, NY
National Provider Identifier
1649481219
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
INTENSIVE CASE MANAGEMENT PROGRAM
Practice address
1841 Brentwood Rd
Brentwood, NY 11717-4625
Phone
(631) 853-2762
Fax
(631) 853-2779
NPI assigned
May 25, 2007
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Doreen Desmond, LCSW
Title
Case Manager
Phone
(631) 853-2762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NY Primary

Addresses

Primary practice location

1841 Brentwood Rd
Brentwood, NY 11717-4625

Mailing address

1841 Brentwood Rd
Brentwood, NY 11717-4625
Phone (631) 853-2762

National Provider Directory

National Provider Directory
Tax ID family
Teresa M Cheng17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1649481219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 BRENTWOOD RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174625",
            "telephone_number": "631-853-2762",
            "fax_number": "631-853-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 BRENTWOOD RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174625",
            "telephone_number": "631-853-2762",
            "fax_number": "631-853-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE CASE MANAGEMENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "DESMOND",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "631-853-2762",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.