=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053463828
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 MOORE AVE
-----------------------------------------------------
City | MOUNT KISCO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10549-3112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-864-7101
-----------------------------------------------------
Fax | 914-864-7121
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 MOORE AVE
-----------------------------------------------------
City | MOUNT KISCO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10549-3112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-864-7101
-----------------------------------------------------
Fax | 914-864-7121
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CENTER DIRECTOR
-----------------------------------------------------
Name | DR. MICHAEL FEMINELLA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 914-864-7101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | R044338-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------