Healthcare Provider Details

I. General information

NPI: 1811088719
Provider Name (Legal Business Name): THE NEIGHBORHOOD CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 MARY ST
UTICA NY
13501-2419
US

IV. Provider business mailing address

624 ELIZABETH ST
UTICA NY
13501-2413
US

V. Phone/Fax

Practice location:
  • Phone: 315-272-2700
  • Fax: 315-732-2229
Mailing address:
  • Phone: 315-272-2600
  • Fax: 315-732-0353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7998120A
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7998120A
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SANDRA SOROKA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 315-272-2600