# OTSEGO COUNTY CHEMICAL DEPENDENCY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386071280
- **Authorized official:** MR. JUSTIN THALHEIMER LCSW, CASAC (PROGRAM MANAGER)
- **Authorized official phone:** (607) 431-1030

## Contact information

- **Practice address:** 242 MAIN ST, ONEONTA, NY 13820-2527
- **Practice address phone:** (607) 431-1030
- **Mailing address:** 242 MAIN ST, ONEONTA, NY 13820-2527
- **Mailing address phone:** (607) 431-1030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NY | Yes |

## Other

- **Enumeration date:** 10/09/2013
- **Last updated:** 10/09/2013