| Clinic | |
|
260 S Pearl St Albany NY 12202-1809 | |
| (518) 447-4555 | |
| (518) 447-4661 |
| Full Name | Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 260 S Pearl St, Albany, New York |
| Authorized Official Name and Position | Robin B Siegal (DIRECTOR) |
| Authorized Official Contact | 5184474537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinic 175 Green Street Albany NY 12202-2011 Ph: (518) 447-4537 | Clinic 260 S Pearl St Albany NY 12202-1809 Ph: (518) 447-4555 |
| NPI Number | 1245399351 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 09/23/2008 |
| Medicare PECOS PAC ID | 8224941331 |
|---|---|
| Medicare Enrollment ID | O20080425000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245399351 | NPI | - | NPPES |
| 00554774 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 6901100A (New York) | Primary |
| Provider Name | Joshua A Heller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548442353 PECOS PAC ID: 5496748071 Enrollment ID: I20040407001547 |
| Provider Name | Steven D Kronick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144215344 PECOS PAC ID: 4981660255 Enrollment ID: I20041208000517 |
| Provider Name | Patricia I Mutterer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114933165 PECOS PAC ID: 9032146261 Enrollment ID: I20050720000142 |
| Provider Name | Mary P Halloran Ruhle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730236142 PECOS PAC ID: 3577574573 Enrollment ID: I20060505000715 |
| Provider Name | David M Pallas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417162611 PECOS PAC ID: 9032271432 Enrollment ID: I20081218000579 |
| Provider Name | Thomas A Qualtere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942476916 PECOS PAC ID: 6406918812 Enrollment ID: I20081218000675 |
| Provider Name | Risa H Lenney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942450077 PECOS PAC ID: 0941362834 Enrollment ID: I20081231000436 |
| Provider Name | Cindy G Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649288622 PECOS PAC ID: 4385706142 Enrollment ID: I20090105000059 |
| Provider Name | Vanessa L Cayford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033369376 PECOS PAC ID: 7911048194 Enrollment ID: I20100111000109 |
| Provider Name | Brian Cuccolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952776031 PECOS PAC ID: 5799089876 Enrollment ID: I20160210001536 |
| Provider Name | Laurie A Lavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811435217 PECOS PAC ID: 5193095008 Enrollment ID: I20170726001965 |
| Provider Name | Elizabeth Rose Ahner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568802494 PECOS PAC ID: 0042576407 Enrollment ID: I20171117001785 |
| Provider Name | Maria Christina Lenseth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356748206 PECOS PAC ID: 2365782141 Enrollment ID: I20190313002231 |
Tom D'agostino, Ph.d. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Pine West Plz Ste 512, Albany, NY 12205 Phone: 914-438-3991 | |
Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 South Manning Blvd, Suite 6512, Albany, NY 12208 Phone: 518-525-1304 | |
Threat Assessment & Risk Management Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 980 Western Ave, Albany, NY 12203 Phone: 518-439-2379 | |
Rainbow Access Initiative Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Colvin Ave Ste 102, Albany, NY 12206 Phone: 518-438-2222 | |
Evelyn Karpel, Mental Health Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 756 Madison Ave Ste 202, Albany, NY 12208 Phone: 518-217-5742 | |
Case Management Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 175 Green Street, Albany, NY 12202 Phone: 518-447-4550 Fax: 518-447-2045 | |
National Alliance On Mental Illness-new York State Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 99 Pine St, Suite 105, Albany, NY 12207 Phone: 518-462-2000 |