| Southern Tier Nurse Practitioners In Psychiatry | |
|
141 Chautauqua Ave Lakewood NY 14750-1278 | |
| (716) 489-8850 | |
| Not Available |
| Full Name | Southern Tier Nurse Practitioners In Psychiatry |
|---|---|
| Speciality | Clinic/Center |
| Location | 141 Chautauqua Ave, Lakewood, New York |
| Authorized Official Name and Position | Clinton George (PROVIDER) |
| Authorized Official Contact | 7164898850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Tier Nurse Practitioners In Psychiatry 141 Chautauqua Ave Lakewood NY 14750-1278 Ph: (716) 489-8850 | Southern Tier Nurse Practitioners In Psychiatry 141 Chautauqua Ave Lakewood NY 14750-1278 Ph: (716) 489-8850 |
| NPI Number | 1225725880 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/22/2023 |
| Medicare PECOS PAC ID | 4183068752 |
|---|---|
| Medicare Enrollment ID | O20240222001390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225725880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Clinton T George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821606237 PECOS PAC ID: 0143628651 Enrollment ID: I20220307000091 |
| Provider Name | Margaret Elizabeth Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659944171 PECOS PAC ID: 7315327699 Enrollment ID: I20220705000232 |
Step Forward Applied Behavior Analysis Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 962 Pewter Rock, Lakewood, NY 14750 Phone: 716-338-7769 |