Healthcare Provider Details

I. General information

NPI: 1508565466
Provider Name (Legal Business Name): CORTLAND COUNTY COUNTY TREASURER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CLAYTON AVE
CORTLAND NY
13045-2501
US

IV. Provider business mailing address

7 CLAYTON AVE
CORTLAND NY
13045-2501
US

V. Phone/Fax

Practice location:
  • Phone: 607-758-6100
  • Fax: 607-758-6116
Mailing address:
  • Phone: 607-758-6100
  • Fax: 607-758-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NANCY J SMITH
Title or Position: EXECUTIVE ADMINISTRATIVE OFFICER
Credential:
Phone: 607-758-6100