NPIMap

Organization Active NPI

County of Otsego

Doing business as Otsego County Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oneonta, NY
National Provider Identifier
1831145101
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6635100A Issued in NY
Legal business name
COUNTY OF OTSEGO
Doing business as
Otsego County Mental Health Clinic
Practice address
242 Main St
Oneonta, NY 13820-2527
Phone
(607) 433-2343
Fax
(607) 433-6229
NPI assigned
May 26, 2006
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Ms. Susan A Matt, LCSW/CASACNPI 1891735429
Title
Director of Community Services
Phone
(607) 433-2343

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6635100A NY Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

242 Main St
Oneonta, NY 13820-2527

Mailing address

242 Main St
Oneonta, NY 13820-2527
Phone (607) 433-2343

Other names 1

  • Otsego County Mental Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000885 NY Part B Supplier - Clinic/Group Practice 9032195573 Receives reassigned benefits from 11 practitioners
Practice locations: Oneonta, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ostego Mental Health SE11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1831145101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MAIN ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202527",
            "telephone_number": "607-433-2343",
            "fax_number": "607-433-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MAIN ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202527",
            "telephone_number": "607-433-2343",
            "fax_number": "607-433-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF OTSEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "MATT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY SERVICES",
        "authorized_official_telephone_number": "607-433-2343",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW/CASAC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "6635100A",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otsego County Mental Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oneonta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.