| County Of Orange, Department Of Mental Health | |
|
146 Pike Street Port Jervis NY 12771 | |
| (845) 858-1456 | |
| (845) 858-1459 |
| Full Name | County Of Orange, Department Of Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 146 Pike Street, Port Jervis, New York |
| Authorized Official Name and Position | Indira Smith (PROGRAM EVALUATION ASSISTANT) |
| Authorized Official Contact | 8452912902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Orange, Department Of Mental Health 30 Harrman Drive Goshen NY 10924 Ph: (845) 291-2600 | County Of Orange, Department Of Mental Health 146 Pike Street Port Jervis NY 12771 Ph: (845) 858-1456 |
| NPI Number | 1740227214 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 07/08/2021 |
| Certification Date | 07/08/2021 |
| Medicare PECOS PAC ID | 0648169185 |
|---|---|
| Medicare Enrollment ID | O20040312000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740227214 | NPI | - | NPPES |
| 03004253 | Medicaid | NY | |
| 00542503 | Medicaid | NY |
| Provider Name | Abdul Qayyum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588716559 PECOS PAC ID: 3678487220 Enrollment ID: I20031118000153 |
| Provider Name | Tasbeeh Fatima |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972657997 PECOS PAC ID: 3678561032 Enrollment ID: I20040504000946 |
| Provider Name | Oscar Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326364621 PECOS PAC ID: 6507880499 Enrollment ID: I20060118000721 |
| Provider Name | Alison Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386852341 PECOS PAC ID: 9830283050 Enrollment ID: I20070919000529 |
| Provider Name | Barbara A Manco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487648812 PECOS PAC ID: 6406945971 Enrollment ID: I20071205000747 |
| Provider Name | Joseph J Perales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396923876 PECOS PAC ID: 2860579935 Enrollment ID: I20080414000590 |
| Provider Name | Linda J Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871651109 PECOS PAC ID: 3274612031 Enrollment ID: I20080505000471 |
| Provider Name | Victoria Mazur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336205830 PECOS PAC ID: 9133298813 Enrollment ID: I20080521000304 |
| Provider Name | Martha M Thomson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417149659 PECOS PAC ID: 6901960038 Enrollment ID: I20090204000046 |
| Provider Name | Minerva Torres Orta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356407183 PECOS PAC ID: 1850433913 Enrollment ID: I20100127000773 |
| Provider Name | Victoria A Caruso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225178841 PECOS PAC ID: 1052435930 Enrollment ID: I20100830000320 |
| Provider Name | Marie C Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649346966 PECOS PAC ID: 8921282385 Enrollment ID: I20110408000212 |
| Provider Name | Diane S Baynon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053513648 PECOS PAC ID: 0345428595 Enrollment ID: I20110617000290 |
| Provider Name | Sharon Cherian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427365055 PECOS PAC ID: 6800048182 Enrollment ID: I20121213000113 |
| Provider Name | Saeed I Bhatti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598953531 PECOS PAC ID: 5193970978 Enrollment ID: I20130227000612 |
| Provider Name | Margaret Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194065383 PECOS PAC ID: 2062646276 Enrollment ID: I20131001000375 |
| Provider Name | Anne M Glenn Fellenzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801044326 PECOS PAC ID: 3375768245 Enrollment ID: I20140709000666 |
| Provider Name | Heather Marie Fitzharris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356692453 PECOS PAC ID: 6406075084 Enrollment ID: I20140912001344 |
| Provider Name | Leah Ann Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801128384 PECOS PAC ID: 6800017716 Enrollment ID: I20141017001494 |
| Provider Name | Linda Fasano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699054460 PECOS PAC ID: 0042441495 Enrollment ID: I20150821014152 |
| Provider Name | Kristen Moses-westphal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922252378 PECOS PAC ID: 7517274798 Enrollment ID: I20150921002255 |
| Provider Name | Molly Mccarthy Tweedy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427292655 PECOS PAC ID: 2466762679 Enrollment ID: I20151029002698 |
| Provider Name | Taniesha B Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184962185 PECOS PAC ID: 8224338363 Enrollment ID: I20151123000499 |
| Provider Name | Jessica Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992146450 PECOS PAC ID: 3072814375 Enrollment ID: I20151210000630 |
| Provider Name | Julie Biagiotti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326425075 PECOS PAC ID: 9335439512 Enrollment ID: I20160531000965 |
| Provider Name | Daniel Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639210685 PECOS PAC ID: 3577841287 Enrollment ID: I20161101001297 |
| Provider Name | Sylvia Denise Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295127348 PECOS PAC ID: 3971856006 Enrollment ID: I20181019000209 |
| Provider Name | Analee Figueroa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518360668 PECOS PAC ID: 4789917204 Enrollment ID: I20190614000480 |
| Provider Name | Stephanie R Bifolco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174167662 PECOS PAC ID: 1658785241 Enrollment ID: I20210121002350 |
| Provider Name | Jessica Pamela Lesmana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154784262 PECOS PAC ID: 0547675928 Enrollment ID: I20210217000414 |
| Provider Name | Angelyn E Galati |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295128866 PECOS PAC ID: 6103233168 Enrollment ID: I20210318002801 |
| Provider Name | Anthony R Collica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558938548 PECOS PAC ID: 4486036936 Enrollment ID: I20220801002160 |
| Provider Name | Shantel Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376279588 PECOS PAC ID: 2062895683 Enrollment ID: I20220815003062 |
| Provider Name | Sarah Manco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396907598 PECOS PAC ID: 3678736238 Enrollment ID: I20221117000077 |
| Provider Name | Renee Sampson Woodard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912176132 PECOS PAC ID: 8527436542 Enrollment ID: I20221123001544 |
| Provider Name | Nichole C Delavega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598451841 PECOS PAC ID: 0941667000 Enrollment ID: I20230605001765 |
| Provider Name | Andrea Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649860818 PECOS PAC ID: 4284091976 Enrollment ID: I20230612002685 |
| Provider Name | Chelesa D Turnbull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013567692 PECOS PAC ID: 0840658498 Enrollment ID: I20230614001916 |
| Provider Name | Lucinda Figueroa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649752668 PECOS PAC ID: 2567807795 Enrollment ID: I20240228000608 |
| Provider Name | Janan Furlong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689215352 PECOS PAC ID: 6002257110 Enrollment ID: I20240507002372 |
| Provider Name | Shayna Kostenbader |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447806195 PECOS PAC ID: 4688015308 Enrollment ID: I20240513002548 |
Marian Susan Sanborn Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 136 Jersey Ave, Port Jervis, NY 12771 Phone: 845-328-0133 | |
Jeremy A. Freeman Psychoanalysis Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Beach Rd, Port Jervis, NY 12771 Phone: 845-702-8044 | |
Orange County Dept Of Menttal Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 146 Pike St, Port Jervis, NY 12771 Phone: 845-858-1456 Fax: 845-858-1459 | |
Built For Growth Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 84 Front St Ste A, Port Jervis, NY 12771 Phone: 718-913-0234 | |
Bon Secours Community Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 160 E Main St, Port Jervis, NY 12771 Phone: 845-858-7000 Fax: 845-858-7415 |