Organization
CHILDREN'S HOME OF JEFFERSON COUNTY
Active
Other names
Community Clinic of Jefferson County
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE L MONNAT LMHC (PRESIDENT AND CEO)
(315) 788-7430
Entity
Organization
Contact information
Practice address
211 JB WISE PL, WATERTOWN, NY 13601-2507
(315) 782-7445
(315) 779-1184
Mailing address
PO BOX 6550, 1704 STATE STREET, WATERTOWN, NY 13601-6550
(315) 788-7430
(315) 785-5637
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
9298014A
NY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
03A2861
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3372621
—
NY
01
—
9298014A
NEW YORK STATE OFFICE OF MENTAL HEALTH/OPERATING CERTIFICATE
NY
Enumeration date
06/27/2011
Last updated
07/08/2024
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