Healthcare Provider Details

I. General information

NPI: 1891948121
Provider Name (Legal Business Name): SAMUEL G CALI LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALFRED COUNSELING ASSOCIATE

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 08/05/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 STATE ROUTE 244
ALFRED STATION NY
14803-0041
US

IV. Provider business mailing address

PO BOX 41
ALFRED STATION NY
14803-0041
US

V. Phone/Fax

Practice location:
  • Phone: 607-587-8390
  • Fax: 585-335-9553
Mailing address:
  • Phone: 607-587-8390
  • Fax: 585-335-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number003048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: