| Harry Stack Sullivan Mental Health Services | |
|
5 Court St Suite 42, County Office Building Norwich NY 13815-1695 | |
| (607) 337-1602 | |
| (607) 334-4519 |
| Full Name | Harry Stack Sullivan Mental Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Court St, Norwich, New York |
| Authorized Official Name and Position | Elizabeth Warneck (DIRECTOR OF COMMUNITY SERVICES) |
| Authorized Official Contact | 6073371600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harry Stack Sullivan Mental Health Services 5 Court St Suite 42, County Office Building Norwich NY 13815-1695 Ph: (607) 337-1602 | Harry Stack Sullivan Mental Health Services 5 Court St Suite 42, County Office Building Norwich NY 13815-1695 Ph: (607) 337-1602 |
| NPI Number | 1003846270 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 5597658344 |
|---|---|
| Medicare Enrollment ID | O20040205000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003846270 | NPI | - | NPPES |
| 00581246 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6861100A (New York) | Primary |
| Provider Name | Eric R Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669551560 PECOS PAC ID: 0143294405 Enrollment ID: I20040823000799 |
| Provider Name | David E Carr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720008717 PECOS PAC ID: 2769458173 Enrollment ID: I20040908000143 |
| Provider Name | Ashok Goyal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760507677 PECOS PAC ID: 5496887473 Enrollment ID: I20100712000247 |
| Provider Name | Joy M Magnussen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649454596 PECOS PAC ID: 3072700970 Enrollment ID: I20101203001001 |
| Provider Name | Elena Ficicchia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447435102 PECOS PAC ID: 0042490427 Enrollment ID: I20110203000023 |
| Provider Name | Stephanie J Pickens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578747523 PECOS PAC ID: 0749459295 Enrollment ID: I20110817000928 |
| Provider Name | Elizabeth A Warneck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730349325 PECOS PAC ID: 9133391782 Enrollment ID: I20111004000570 |
| Provider Name | Matthew Skojec |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528221991 PECOS PAC ID: 3274700240 Enrollment ID: I20120113000440 |
| Provider Name | Kiernan L Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992965586 PECOS PAC ID: 6709053408 Enrollment ID: I20120120000567 |
| Provider Name | Robert D Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467733550 PECOS PAC ID: 4981861184 Enrollment ID: I20120627000003 |
| Provider Name | Tiffany A Rivenburgh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942562178 PECOS PAC ID: 9638325954 Enrollment ID: I20120801000834 |
| Provider Name | Kelly L Hunter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033407408 PECOS PAC ID: 1951558980 Enrollment ID: I20120828000009 |
| Provider Name | Angela Monuszko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235366022 PECOS PAC ID: 0840454526 Enrollment ID: I20130413000093 |
| Provider Name | Donna G Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073702296 PECOS PAC ID: 8426291758 Enrollment ID: I20130905000270 |
| Provider Name | Lisa L Schulz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811266141 PECOS PAC ID: 7719263540 Enrollment ID: I20170411000717 |
| Provider Name | Allison Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477090611 PECOS PAC ID: 2062787476 Enrollment ID: I20171011002637 |
| Provider Name | Vincent J Nucero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811333511 PECOS PAC ID: 9436495207 Enrollment ID: I20190115003746 |
| Provider Name | Irina I Gordeyeva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013367341 PECOS PAC ID: 6103253463 Enrollment ID: I20200226000860 |
| Provider Name | Sarah C Nucero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154788925 PECOS PAC ID: 6305268749 Enrollment ID: I20200612000495 |
| Provider Name | Karlee L Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932564655 PECOS PAC ID: 4385051564 Enrollment ID: I20210406001574 |
| Provider Name | Heather R Kolb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801387543 PECOS PAC ID: 3274933312 Enrollment ID: I20210611001043 |
| Provider Name | Pamela A Pucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326296344 PECOS PAC ID: 6002208113 Enrollment ID: I20220124001264 |
| Provider Name | Kay M Drebert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235793548 PECOS PAC ID: 2961866843 Enrollment ID: I20230911002934 |
Chenango Memorial Hospital, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 179 N Broad St, Norwich, NY 13815 Phone: 607-337-4111 Fax: 607-337-4293 | |
Mark P. Vogel, Ph.d And Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 Midland Dr, Norwich, NY 13815 Phone: 607-336-9914 Fax: 607-334-4881 | |
Harry Stack Sullivan Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Court St, Suite 42, County Office Building, Norwich, NY 13815 Phone: 607-337-1602 Fax: 607-334-4519 |