CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS (NPI# 1760630073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760630073 |
| Entity Type | Organization |
| Organization Name | CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS |
| Practice Address |
595 W Main St Watertown NY 13601 |
| Mailing Address |
595 W Main St Watertown NY 13601-1335 |
| Practice Telephone | 3157881530 |
| Practice Fax Number | 3157883794 |
| Mailing Telephone | 3157881530 |
| Mailing Fax Number | 3157883794 |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2008-08-29 |
| Authorized Official Name | JAMES SCORDO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3157881530 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 090310744 | NY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02921011 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740695568 | Credo Community Center for The Treatment of Addictions | Substance Abuse Rehabilitation Facility | 24180 County Route 16, Evans Mills, NY 13637-3127 | 2014-07-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CREDO COMMUNITY CENTER FOR THE TREATMENT OF ADDICTIONS INC | 595 W Main St, Watertown, NY 13601-1335 |
| Street Address |
595 W MAIN ST |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659389021 | Credo Community Center for Treatment of Addictions Inc | Substance Abuse Rehabilitation Facility | 595 W Main St, Watertown, NY 13601-1335 | 2006-08-03 |
| 1891330544 | Ashley Shaun Peppers | Social Worker | 595 W Main St, Watertown, NY 13601-1335 | 2019-11-16 |
| 1578928339 | Melinda Gabriel | Marriage & Family Therapist | 595 W Main St, Watertown, NY 13601-1335 | 2015-12-22 |
| 1902204464 | Elise Labatore | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2014-12-16 |
| 1609023167 | Patricia Fralick | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| 1013164565 | Kim Downey | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| 1699922146 | Chris Mcdonald | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| 1851548325 | Joanne Nugent | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| 1326295809 | Caryn White | Social Worker | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| 1275780728 | Randy Gardner | Counselor | 595 W Main St, Watertown, NY 13601-1335 | 2008-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881228682 | Every Rose LLC | Community/Behavioral Health | 101 Siemon Company Dr # 236w, Watertown, CT 06795-2651 | 2020-03-02 |
| 1285275545 | Jennifer Schneider, Licsw, LLC | Community/Behavioral Health | 58 Cuba St, Watertown, MA 02472-2345 | 2019-10-07 |
| 1396232187 | Watertown Wellness Center LLC | Community/Behavioral Health | 116 Georgetown Drive, Watertown, CT 06795 | 2018-04-17 |
| 1891123956 | Compass Counseling and Assessments Inc. | Community/Behavioral Health | 103 19th St Ne, Watertown, SD 57201-2823 | 2013-10-28 |
| 1568740363 | Gymtastics, Inc | Community/Behavioral Health | 925 S 12th St, Watertown, WI 53094-7101 | 2011-07-27 |
| 1962735472 | Boston Aba | Community/Behavioral Health | 124 Watertown St Ste 2e, Watertown, MA 02472-2500 | 2009-09-15 |
| 1568912467 | Sarah Eknaian | Community/Behavioral Health | 552 Main St, Watertown, MA 02472-2224 | 2016-10-04 |
| 1851844534 | Safe Journey Counseling, LLC | Community/Behavioral Health | 76 Westbury Park Rd, Watertown, CT 06795-2779 | 2016-07-28 |
| 1245683978 | Lotus Counseling of Connecticut LLC | Community/Behavioral Health | 27 Siemon Company Dr, Suite 360w, Watertown, CT 06795-2654 | 2016-07-18 |
| 1790169795 | The Mental Health Association In Jefferson County, Inc. | Community/Behavioral Health | 425 Washington St, Watertown, NY 13601-3735 | 2015-07-20 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.