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General NPI Number Information
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NPI Number | 1588686596
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Entity Type | Organization
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Legal Business Name | TOMPKINS COUNTY MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 201 E GREEN ST
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City | ITHACA
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State | NY
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Zip | 14850-5421
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Country | US
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Telephone | 607-274-6305
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Fax | 607-274-6316
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Provider Business Mailing Address
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Address Line | 201 E GREEN ST
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City | ITHACA
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State | NY
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Zip | 14850-5421
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Country | US
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Telephone | 607-274-6305
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Fax | 607-274-6316
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Authorized Official
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Title or Position | FISCAL ADMINISTRATOR
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Name | JEREMY PORTER
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Credential |
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Telephone | 607-274-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6892300A
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License Number State | NY
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