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General NPI Number Information
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NPI Number | 1629094065
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Entity Type | Organization
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Legal Business Name | BROOME COUNTY MENTAL HEALTH DEPARTMENT
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 36-42 MAIN STREET
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-778-6357
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Fax | 607-778-6189
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Provider Business Mailing Address
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Address Line | 36-42 MAIN STREET
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-778-6357
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Fax | 607-778-6189
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Authorized Official
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Title or Position | COMMISSIONER
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Name | MR. ARTHUR R. JOHNSON
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Credential | LCSW
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Telephone | 607-778-6357
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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 |
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License Number State |
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Taxonomy #2
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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 |
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License Number State | NY
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