NPIMap

Organization Active NPI

Catholic Charities of the Diocese of Rockville Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Freeport, NY
National Provider Identifier
1831110972
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6814107A Issued in NY
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Practice address
333 N Main St
Freeport, NY 11520-1231
Phone
(516) 623-3322
NPI assigned
Jul 22, 2006
Last updated
Aug 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Richard Balcom
Title
Cfo
Phone
(516) 733-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6814107A NY Primary

Addresses

Primary practice location

333 N Main St
Freeport, NY 11520-1231

Mailing address

90 Cherry LN
Hicksville, NY 11801-6232
Phone (516) 733-7040

Other identifiers 1

IdentifierTypeStateIssuer
6814107AOtherNYOMH OPERATING CERTIFICATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000332 NY Part B Supplier - Clinic/Group Practice 9436137908 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, NY; Hampton Bays, NY; Bayshore, NY

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

259 Mineola Blvd
Mineola, NY 11501
Phone (516) 248-7100

Practitioners & affiliated clinicians

Practitioners 60

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 60

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1831110972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CHERRY LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016232",
            "telephone_number": "516-733-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201231",
            "telephone_number": "516-623-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "BALCOM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-733-7032"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "6814107A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMH OPERATING CERTIFICATE",
            "identifier": "6814107A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.