NPIMap

Organization Active NPI

Children's Home of Jefferson County

  • Case Management Agency
  • Watertown, NY
National Provider Identifier
1770625527
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CHILDREN'S HOME OF JEFFERSON COUNTY
Practice address
211 JB Wise PL
Watertown, NY 13601-2507
Phone
(315) 779-1507
NPI assigned
Feb 12, 2007
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Michelle Lynn Monnat, LMHCNPI 1982130738
Title
President and Ceo
Phone
(315) 777-9747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

211 JB Wise PL
Watertown, NY 13601-2507

Mailing address

PO Box 6550
Watertown, NY 13601-6550
Phone (315) 777-9747

Other practice location 1

80 State Highway 310
Canton, NY 13617-1436
Phone (315) 788-7430

Other identifiers 1

IdentifierTypeStateIssuer
02502243MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Children's Home of Jefferson County4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

167 Polk St
Ste 300
Watertown, NY 13601

Practitioners & affiliated clinicians

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 107

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1770625527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6550",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136016550",
            "telephone_number": "315-777-9747",
            "fax_number": "315-785-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 JB WISE PL",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012507",
            "telephone_number": "315-779-1507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 State Highway 310",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "136171436",
            "country_code": "US",
            "telephone_number": "315-788-7430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILDREN'S HOME OF JEFFERSON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "MONNAT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "315-777-9747",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02502243",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.