Organization
COUNTY OF OTSEGO
Active
Other names
Otsego County Mental Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN A MATT LCSW/CASAC (DIRECTOR OF COMMUNITY SERVICES)
(607) 433-2343
Entity
Organization
Contact information
Practice address
242 MAIN ST, ONEONTA, NY 13820-2527
(607) 433-2343
(607) 433-6229
Mailing address
242 MAIN ST, ONEONTA, NY 13820-2527
(607) 433-2343
(607) 433-6229
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6635100A
NY
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03004473
—
NY
01
—
115687
EXCELLUS BC/BS
—
01
—
Z4118
EMPIRE BC/BS
—
Enumeration date
05/26/2006
Last updated
08/06/2015
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