Healthcare Provider Details

I. General information

NPI: 1477609691
Provider Name (Legal Business Name): M CHRISTINE PRELL LCSW-R CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY CHRISTINE SARCHIOTO

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 STATE ROUTE 11
CHAMPLAIN NY
12919-4966
US

IV. Provider business mailing address

9 CAREY RD
QUEENSBURY NY
12804-7880
US

V. Phone/Fax

Practice location:
  • Phone: 518-298-2691
  • Fax: 518-298-8241
Mailing address:
  • Phone: 518-761-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number075688
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier03019270
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: