Tractorhealthsolutions LLC

Organization Active NPI Clinical Social Worker · Port Ewen, NY

NPI 1861946154 · NPPES record last updated Aug 11, 2016

Key facts

NPI
1861946154
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
080579 (NY)
Legal business name
TRACTORHEALTHSOLUTIONS LLC
Practice address
243 Bayard Street
# 724
Port Ewen, NY 12466
Phone
(646) 249-5767
NPI assigned
Aug 4, 2016
Organization subpart
No

Authorized official

Name
William Latimer, LCSW R
Title
Ceo
Phone
64672495767

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X 23700 NY
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 080579 NY Yes
Case Manager/Care Coordinator
Group: 193200000X MULTI-SPECIALTY GROUP
171M00000X 080579 NY

Addresses

Primary practice location

243 Bayard Street
# 724
Port Ewen, NY 12466

Mailing address

243 Bayard Street
# 724
Port Ewen, NY 12466
Phone (646) 249-5767

Other identifiers

IdentifierTypeStateIssuer
03589764MedicaidNY

Other providers in Port Ewen, NY

All providers in Port Ewen, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.