| Samaritan Counseling Center Of The Mohawk Valley, Inc | |
|
1612 Genesee St Utica NY 13502-5425 | |
| (315) 724-5173 | |
| (315) 724-5323 |
| Full Name | Samaritan Counseling Center Of The Mohawk Valley, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1612 Genesee St, Utica, New York |
| Authorized Official Name and Position | James S Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3157245173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Counseling Center Of The Mohawk Valley, Inc 1612 Genesee St Utica NY 13502-5425 Ph: (315) 724-5173 | Samaritan Counseling Center Of The Mohawk Valley, Inc 1612 Genesee St Utica NY 13502-5425 Ph: (315) 724-5173 |
| NPI Number | 1649377854 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 8921083882 |
|---|---|
| Medicare Enrollment ID | O20040623001086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649377854 | NPI | - | NPPES |
| 110153 | Other | NY | EXCELLUS BLUECROSS BLUESH |
| 415111 | Other | NY | MVP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Reba G Wernsing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518002369 PECOS PAC ID: 4284815929 Enrollment ID: I20110301000027 |
| Provider Name | Deborah A Rowlands |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356650451 PECOS PAC ID: 3375796964 Enrollment ID: I20130110000009 |
| Provider Name | Robert Emmett Christman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902292675 PECOS PAC ID: 6305140104 Enrollment ID: I20160215000778 |
| Provider Name | Latrease R Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497114920 PECOS PAC ID: 7618367566 Enrollment ID: I20211208000548 |
| Provider Name | James Sherwood Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487664082 PECOS PAC ID: 6709144033 Enrollment ID: I20240314003125 |
| Provider Name | Diane Policelli |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649504580 PECOS PAC ID: 7214372762 Enrollment ID: I20240429002016 |
| Provider Name | Pam Elese Koagel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912374802 PECOS PAC ID: 2466893706 Enrollment ID: I20240516003714 |
| Provider Name | Rosalee Ann Klingmeyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407992308 PECOS PAC ID: 3375088826 Enrollment ID: I20240709003821 |
| Provider Name | Amanda S Holbrook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881971661 PECOS PAC ID: 4789129032 Enrollment ID: I20240711001703 |
| Provider Name | Candace N. Thornton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679285316 PECOS PAC ID: 8729525134 Enrollment ID: I20240802002603 |
| Provider Name | Debra S Betti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295480804 PECOS PAC ID: 4688031701 Enrollment ID: I20240926004438 |
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