|
| |
|
7 Erie Ave Narrowsburg NY 12764-6423 | |
| (845) 828-0299 | |
| (866) 428-0282 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 7 Erie Ave, Narrowsburg, New York |
| Authorized Official Name and Position | Thomas Scott Rue (MEMBER) |
| Authorized Official Contact | 6684280282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 706 Monticello NY 12701-0706 Ph: (845) 323-9612 | 7 Erie Ave Narrowsburg NY 12764-6423 Ph: (845) 828-0299 |
| NPI Number | 1871892034 |
|---|---|
| Provider Enumeration Date | 03/26/2011 |
| Last Update Date | 11/12/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 8820538846 |
|---|---|
| Medicare Enrollment ID | O20240905001141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871892034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10741 (New York) | Secondary |
| 101YM0800X | Counselor - Mental Health | 000461 (New York) | Primary |
| Provider Name | Thomas Scott Rue |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548588023 PECOS PAC ID: 3375995061 Enrollment ID: I20240923000033 |