Essential Adirondack Therapy License Clinical Social Work, PLLC.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ESSENTIAL ADIRONDACK THERAPY LICENSE CLINICAL SOCIAL WORK, PLLC.

Doing business as

Essential Adirondack Therapy

Practice address

128 Corlear Dr
Willsboro, NY 12996-4144

Phone

(518) 420-5671

NPI assigned

Dec 2, 2022

Last updated

Dec 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara L Hurlburt, LCSWNPI 1174077846

Title

LCSW/ Owner Operator

Phone

(518) 572-9920

Specialties & licenses 1

Addresses

Other names 1

• Essential Adirondack Therapy Doing business as

Locations

Practitioners 1

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.

• Sara L Hurlburt, LCSW

  • Clinical Social Worker
  • Elizabethtown, NY
  • NPI 1174077846
  NPD Authorized official

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1831809631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 ROSCOE RD",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "129322407",
            "telephone_number": "518-572-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CORLEAR DR",
            "city": "WILLSBORO",
            "state": "NY",
            "postal_code": "129964144",
            "telephone_number": "518-420-5671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63 Roscoe Rd",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NY",
            "postal_code": "129322407",
            "country_code": "US",
            "telephone_number": "518-572-9920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ESSENTIAL ADIRONDACK THERAPY LICENSE CLINICAL SOCIAL WORK, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "HURLBURT",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LCSW/ OWNER OPERATOR",
        "authorized_official_telephone_number": "518-572-9920",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essential Adirondack Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Willsboro, NY
• Providers in Willsboro, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.