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General NPI Number Information
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NPI Number | 1497737167
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Entity Type | Organization
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Legal Business Name | PUTNAM FAMILY AND COMMUNITY SERVICES INC
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 1808 ROUTE 6
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City | CARMEL
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State | NY
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Zip | 10512
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Country | US
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Telephone | 845-225-2700
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Fax | 845-225-3207
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Provider Business Mailing Address
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Address Line | 1808 ROUTE 6
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City | CARMEL
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State | NY
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Zip | 10512
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Country | US
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Telephone | 845-225-2700
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Fax | 845-225-3207
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER/ DIRECTOR
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Name | DIANE E RUSSO
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Credential |
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Telephone | 845-225-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9041100A
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License Number State | NY
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