Organization
ONONDAGA CASE MANAGEMENT SERVICES INC.
Active
Other names
Circare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT EBNER (EXECUTIVE DIRECTOR)
(315) 472-7363
Entity
Organization
Contact information
Practice address
620 ERIE BLVD W STE 302, SYRACUSE, NY 13204-2463
(315) 472-7363
(315) 472-0084
Mailing address
620 ERIE BLVD W STE 302, SYRACUSE, NY 13204-2463
(315) 472-7363
(315) 472-0084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
VARIOUS THERAPISTS
NY
103TP0016X
Prescribing (Medical) Psychologist
VARIOUS
NY
104100000X
Social Worker
VARIOUS LICENSES
NY
251B00000X
Case Management Agency
Primary
NOT LICENSED IN NYS
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01212142
—
NY
05
—
02382218
—
NY
05
—
02717628
—
NY
05
—
02994838
—
NY
01
—
8044025A
BEHAVIORAL HEALTH CLINIC-OMH OPERATING CERTIFICATE
NY
01
—
8044479A
CASE MANAGEMENT OMH-OPERATING CERTIFICATE
NY
01
—
BA1047
MCR PTAN
—
Enumeration date
05/24/2006
Last updated
09/16/2022
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