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1668 Vandervort Hill Rd Unadilla NY 13849-2394 | |
(607) 369-9043 | |
(607) 369-9043 |
Full Name | |
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Speciality | Social Worker |
Location | 1668 Vandervort Hill Rd, Unadilla, New York |
Authorized Official Name and Position | Jeanne M Racioppi (CLINICAL DIRECTOR) |
Authorized Official Contact | 5166601741 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1668 Vandervort Hill Rd Unadilla NY 13849-2394 Ph: (607) 369-9043 | 1668 Vandervort Hill Rd Unadilla NY 13849-2394 Ph: (607) 369-9043 |
NPI Number | 1245844679 |
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Provider Enumeration Date | 09/02/2020 |
Last Update Date | 07/23/2024 |
Certification Date | 07/23/2024 |
Medicare PECOS PAC ID | 0143767921 |
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Medicare Enrollment ID | O20240730002844 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245844679 | NPI | - | NPPES |
176063759 | Medicaid | NY | |
1770827602 | Medicaid | NY | |
1932712197 | Medicaid | NY | |
1023532447 | Medicaid | NY | |
1467804989 | Medicaid | NY |
Provider Name | Jeanne M Racioppi |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1770827602 PECOS PAC ID: 1052858834 Enrollment ID: I20240730003012 |
Samantha Cole Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1004 State Highway 7 Bldg B, Unadilla, NY 13849 Phone: 607-354-4602 Fax: 607-215-4201 |