Timothy Czelusniak Serviss, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

34114 Issued in NY

Practice address

159 Glenwood Dr
Saranac Lake, NY 12983-2385

Phone

(518) 891-3950

NPI assigned

Jul 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1821721648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 ELLSWORTH BLVD",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203357",
            "telephone_number": "518-891-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 GLENWOOD DR",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129832385",
            "telephone_number": "518-891-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZELUSNIAK SERVISS",
        "first_name": "TIMOTHY",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "34114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristeen Marie Colby, RPA-C
• Angela Dulac Cook, CCMP, CRANIO THERAPY
• Elisabeth Cottom, PHARM. D.
• Virginia Lee Cuttaia, RN
• Tomas Julius Cyvas
• Heather L Damour, RPH
• Kathryn Clark Dearborn, CRNA
• John White Decker, M.D.
• Sheila Decker
• Monica Dederick

• Addiction (Substance Use Disorder) Counselor in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.