NPIMap

Organization Active NPI

Family Service of the Chautauqua Region Inc

  • Clinical Social Worker
  • Jamestown, NY
National Provider Identifier
1891820171
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FAMILY SERVICE OF THE CHAUTAUQUA REGION INC
Practice address
332 E 4TH St
Jamestown, NY 14701-5502
Phone
(716) 488-1971
Fax
(716) 488-9198
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Authorized official

Name
James McElrath Jr., LCSW-R
Title
Executive Director
Phone
(716) 488-1971

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

332 E 4TH St
Jamestown, NY 14701-5502

Mailing address

332 E 4TH St
Jamestown, NY 14701-5502
Phone (716) 488-1971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050311000692 NY Part B Supplier - Clinic/Group Practice 8729032784 Receives reassigned benefits from 7 practitioners
Practice locations: Jamestown, NY

National Provider Directory

National Provider Directory

Locations

332 E 4th St
Jamestown, NY 14701
Phone (716) 488-1971

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1891820171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E 4TH ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015502",
            "telephone_number": "716-488-1971",
            "fax_number": "716-488-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E 4TH ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015502",
            "telephone_number": "716-488-1971",
            "fax_number": "716-488-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF THE CHAUTAUQUA REGION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "MCELRATH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-488-1971",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.