Credo Community Center for the Treatment of Addictions

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

090310744 Issued in NY

Legal business name

CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS

Practice address

595 W Main St
Watertown, NY 13601

Phone

(315) 788-1530

Fax

(315) 788-3794

NPI assigned

Aug 29, 2008

Organization subpart

No

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

Authorized official

Name

James Scordo

Title

Executive Director

Phone

(315) 788-1530

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Credo Foundation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Credo Community Center for the Treatment of Addictions

  • Substance Abuse Rehabilitation Facility
  • Evans Mills, NY
  • NPI 1740695568
  NPD tax ID
• Thrive Wellness and Recovery, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Watertown, NY
  • NPI 1659389021
  NPD tax ID

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1760630073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011335",
            "telephone_number": "315-788-1530",
            "fax_number": "315-788-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-788-1530",
            "fax_number": "315-788-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "SCORDO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-788-1530"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "090310744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02921011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy A Coughlin, RN,FNP-C
• Johnna W Covey, PT
• William Grace Crane Jr., D.O., F.A.C.S.
• Susan Cranker, M.S.
• Creative Optical, LLC
• Ann Marie Crescent, LCSW
• Karalee Cromwell, LPN
• Crossley Dental Associates PC
• David J. Crossley, DDS
• Erich Crowley

• Community/Behavioral Health Agency in Watertown, NY
• Providers in Watertown, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.