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Organization

TIOGA COUNTY

Active
Parent organization
TIOGA COUNTY
Other names
Tioga County Alcohol and Drug Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
TIOGA COUNTY
Authorized official
SUE ROMANCZUK-SMELCER PH.D, LCSW-R (DIRECTOR OF COMMUNITY SERVICES)
(607) 687-0200
Entity
Organization

Contact information

Practice address
1062 STATE ROUTE 38, OWEGO, NY 13827
(607) 687-0200
(607) 687-0248
Mailing address
1062 STATE ROUTE 38, PO BOX 177, OWEGO, NY 13827
(607) 687-0200
(607) 687-0248

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
071011080
NY
1041C0700X
Clinical Social Worker
2084P0802X
Addiction Psychiatry Physician
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00618162
NY
01
071011080
NYS OASAS OPER. CERT. NO.
NY
Enumeration date
06/18/2007
Last updated
01/30/2012
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