| Delaware County | |
|
243 Delaware Street Walton NY 13856 | |
| (607) 832-5888 | |
| (607) 832-6081 |
| Full Name | Delaware County |
|---|---|
| Speciality | Clinic/Center |
| Location | 243 Delaware Street, Walton, New York |
| Authorized Official Name and Position | Cynthia Heaney (DIRECTOR OF COMMUNITY SERVICES) |
| Authorized Official Contact | 6078325694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware County 243 Delaware Street Walton NY 13856 Ph: (607) 832-5888 | Delaware County 243 Delaware Street Walton NY 13856 Ph: (607) 832-5888 |
| NPI Number | 1740375385 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 12/30/2021 |
| Certification Date | 12/30/2021 |
| Medicare PECOS PAC ID | 1254327380 |
|---|---|
| Medicare Enrollment ID | O20040422001601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740375385 | NPI | - | NPPES |
| 00579240 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Fern J Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063401792 PECOS PAC ID: 6608863659 Enrollment ID: I20040429001443 |
| Provider Name | Douglas D Elston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215045570 PECOS PAC ID: 1951441252 Enrollment ID: I20091217000416 |
| Provider Name | Edward A Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326133752 PECOS PAC ID: 9638366560 Enrollment ID: I20101204000059 |
| Provider Name | Miguel A Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558432864 PECOS PAC ID: 7113244252 Enrollment ID: I20150330000235 |
| Provider Name | Katelyn Clare |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609303882 PECOS PAC ID: 3870863061 Enrollment ID: I20170720002128 |
| Provider Name | Crystal Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356887657 PECOS PAC ID: 1456766104 Enrollment ID: I20210211000038 |
| Provider Name | Dara A Yastrzemski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962153809 PECOS PAC ID: 4880074509 Enrollment ID: I20220712000334 |
| Provider Name | Sara M Cirba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336692136 PECOS PAC ID: 8224552914 Enrollment ID: I20250403001150 |
| Provider Name | Erica A Crook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427691872 PECOS PAC ID: 7517481237 Enrollment ID: I20250403001969 |
| Provider Name | Jennifer Grigoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053026120 PECOS PAC ID: 8628592227 Enrollment ID: I20250404000660 |
| Provider Name | Jennifer Isaacson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376817502 PECOS PAC ID: 1759805237 Enrollment ID: I20250407000162 |
| Provider Name | Amy Melson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831860832 PECOS PAC ID: 2062930555 Enrollment ID: I20250519001685 |
Catherine Mccarthy Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4664 County Highway 23, Walton, NY 13856 Phone: 713-410-5607 |