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General NPI Number Information
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NPI Number | 1891820171
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE OF THE CHAUTAUQUA REGION INC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 332 E 4TH ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-5502
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Country | US
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Telephone | 716-488-1971
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Fax | 716-488-9198
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Provider Business Mailing Address
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Address Line | 332 E 4TH ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-5502
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Country | US
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Telephone | 716-488-1971
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Fax | 716-488-9198
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES MCELRATH JR.
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Credential | LCSW-R
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Telephone | 716-488-1971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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