Organization Active NPI

Judith F Rozsa MSW CSW Cac PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Syracuse, NY
National Provider Identifier
1679648760
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JUDITH F ROZSA MSW CSW CAC PC
Practice address
770 James Street
Suite 215
Syracuse, NY 13203
Phone
(315) 422-0571
Fax
(315) 422-2734
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Judi F Rozsa, LCSW ACSW CASAC
Title
Director
Phone
(315) 422-0571

Specialties & licenses 1

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

Addresses

Primary practice location

770 James Street
Suite 215
Syracuse, NY 13203

Mailing address

770 James Street
Suite 215
Syracuse, NY 13203
Phone (315) 422-0571

Other identifiers 1

IdentifierTypeStateIssuer
01706147MedicaidNY

Other names 1

  • Clinical Counseling Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050512000439 NY Part B Supplier - Clinic/Group Practice 6204877996 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayetteville, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

770 James St
Ste 215
Syracuse, NY 13203
Phone (315) 422-0671

Practitioners & affiliated clinicians

Practitioners 9

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679648760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 JAMES STREET",
            "address_2": "SUITE 215",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-422-0571",
            "fax_number": "315-422-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 JAMES STREET",
            "address_2": "SUITE 215",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-422-0571",
            "fax_number": "315-422-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH F ROZSA MSW CSW CAC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROZSA",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "315-422-0571",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW ACSW CASAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01706147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.