NPIMap

Organization Active NPI

Samaritan Licensed Clinical Social Work, PC

  • Community/Behavioral Health Agency
  • Scotia, NY
National Provider Identifier
1790015212
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
P71596 Issued in NY
Legal business name
SAMARITAN LICENSED CLINICAL SOCIAL WORK, PC
Practice address
220 N Ballston Ave
Scotia, NY 12302-2533
Phone
(518) 374-3514
Fax
(518) 374-9193
NPI assigned
Jan 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Deborah Lee Valiquette
Title
Office Manager
Phone
(518) 374-3514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X P71596 NY Primary

Addresses

Primary practice location

220 N Ballston Ave
Scotia, NY 12302-2533

Mailing address

220 N Ballston Ave
Scotia, NY 12302-2533

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Licensed Clinical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1790015212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N BALLSTON AVE",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123022533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N BALLSTON AVE",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123022533",
            "telephone_number": "518-374-3514",
            "fax_number": "518-374-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN LICENSED CLINICAL SOCIAL WORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "VALIQUETTE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-374-3514"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "P71596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.