Organization
COUNTY OF SULLIVAN
Active
Other names
Sullivan County Department of Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALIF BANSE DSW, MSW (DIRECTOR)
(845) 292-8770
Entity
Organization
Contact information
Practice address
20 COMMUNITY LANE, LIBERTY, NY 12754-0716
(845) 292-8770
(845) 513-2111
Mailing address
PO BOX 716, 20 COMMUNITY LANE, LIBERTY, NY 12754-0716
(845) 292-8770
(845) 513-2110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00398370
—
NY
05
—
01147777
—
NY
01
—
12443
BEACON HEALTH
NY
01
—
143247
GHI
NY
Enumeration date
07/04/2006
Last updated
07/07/2025
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