| Mosaic Community Services | |
|
144 Pine St Ste 140 Kingston NY 12401 | |
| (845) 768-2295 | |
| (845) 523-1251 |
| Full Name | Mosaic Community Services |
|---|---|
| Speciality | Social Worker |
| Location | 144 Pine St Ste 140, Kingston, New York |
| Authorized Official Name and Position | Tabitha Sieloff (OWNER) |
| Authorized Official Contact | 8457682295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Community Services 144 Pine St Ste 140 Kingston NY 12401-4946 Ph: (845) 768-2295 | Mosaic Community Services 144 Pine St Ste 140 Kingston NY 12401 Ph: (845) 768-2295 |
| NPI Number | 1356841209 |
|---|---|
| Provider Enumeration Date | 02/16/2018 |
| Last Update Date | 08/09/2018 |
| Medicare PECOS PAC ID | 2466837828 |
|---|---|
| Medicare Enrollment ID | O20220921001087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356841209 | NPI | - | NPPES |
| 1386911840 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tabitha L Henson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386911840 PECOS PAC ID: 9032419007 Enrollment ID: I20151123002068 |
| Provider Name | Constance M Carr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831718501 PECOS PAC ID: 7810363611 Enrollment ID: I20221019002293 |
| Provider Name | Kristin A Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982328894 PECOS PAC ID: 6103297312 Enrollment ID: I20230126002177 |
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