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General NPI Number Information
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NPI Number | 1396882635
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Entity Type | Organization
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Legal Business Name | COUNSELING SERVICE OF THE EPISCOPAL DIOCESE OF ALBANY, INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 116 S LAKE AVE
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City | ALBANY
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State | NY
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Zip | 12208-3371
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Country | US
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Telephone | 518-465-8728
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Fax | 518-436-3576
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Provider Business Mailing Address
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Address Line | 116 S LAKE AVE
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City | ALBANY
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State | NY
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Zip | 12208-3371
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Country | US
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Telephone | 518-465-8728
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Fax | 518-436-3576
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PETER MINUCCI JR.
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Credential | LCSW
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Telephone | 518-465-8728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NY
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