| Upstate Cerebral Palsy, Inc | |
|
1002 Oswego St Utica NY 13502-5031 | |
| (315) 798-8868 | |
| Not Available |
| Full Name | Upstate Cerebral Palsy, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1002 Oswego St, Utica, New York |
| Authorized Official Name and Position | Geno Decondo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3157246907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Cerebral Palsy, Inc 125 Business Park Dr Utica NY 13502-6305 Ph: (315) 724-6907 | Upstate Cerebral Palsy, Inc 1002 Oswego St Utica NY 13502-5031 Ph: (315) 798-8868 |
| NPI Number | 1780636506 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 5496734758 |
|---|---|
| Medicare Enrollment ID | O20040719001380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780636506 | NPI | - | NPPES |
| 00474180 | Medicaid | NY | |
| 01039156 | Medicaid | NY | |
| 07485394 | Medicaid | NY |
| Provider Name | Stephen Hudyncia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508859273 PECOS PAC ID: 9830183854 Enrollment ID: I20040413000588 |
| Provider Name | Bonnie M Casanova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700873858 PECOS PAC ID: 2567457989 Enrollment ID: I20040415001310 |
| Provider Name | David D Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225050404 PECOS PAC ID: 8729040993 Enrollment ID: I20041029000810 |
| Provider Name | George K Tomy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265426480 PECOS PAC ID: 5395794705 Enrollment ID: I20050112000890 |
| Provider Name | Jane M Prendergast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346322450 PECOS PAC ID: 0345289229 Enrollment ID: I20050429000451 |
| Provider Name | Michael Dejesus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528161338 PECOS PAC ID: 0446290308 Enrollment ID: I20050510000675 |
| Provider Name | Minhaj Uddin Siddiqi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598858458 PECOS PAC ID: 4486695038 Enrollment ID: I20050513000537 |
| Provider Name | James E Frederick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861588469 PECOS PAC ID: 1759322910 Enrollment ID: I20050518000279 |
| Provider Name | Beverly G Ischia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689767204 PECOS PAC ID: 1355382532 Enrollment ID: I20050518000402 |
| Provider Name | Joanne G Mcpherson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831143643 PECOS PAC ID: 6608808803 Enrollment ID: I20050908000809 |
| Provider Name | Vivienne Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861464372 PECOS PAC ID: 4486662905 Enrollment ID: I20060324000493 |
| Provider Name | Sylvia A. Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770536898 PECOS PAC ID: 4981795978 Enrollment ID: I20070806000339 |
| Provider Name | Brij Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841496544 PECOS PAC ID: 8123191574 Enrollment ID: I20080718000335 |
| Provider Name | Jayaraju P Raju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538298963 PECOS PAC ID: 0648331181 Enrollment ID: I20081203000156 |
| Provider Name | Richard S Larkin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1346250081 PECOS PAC ID: 2264583616 Enrollment ID: I20090625000472 |
| Provider Name | John P Kosar |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1538179353 PECOS PAC ID: 1557412806 Enrollment ID: I20090625000552 |
| Provider Name | Paula Vecchio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952392904 PECOS PAC ID: 8325174055 Enrollment ID: I20100331001159 |
| Provider Name | Kristin R Lints |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255666582 PECOS PAC ID: 3971634072 Enrollment ID: I20100707000269 |
| Provider Name | Annette L Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700830510 PECOS PAC ID: 1456476944 Enrollment ID: I20100921001151 |
| Provider Name | Gregory Wood |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376595322 PECOS PAC ID: 6901098623 Enrollment ID: I20101012001347 |
| Provider Name | Morales D Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679775266 PECOS PAC ID: 3577719731 Enrollment ID: I20120803000726 |
| Provider Name | Lora A Abraham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346574340 PECOS PAC ID: 9032359492 Enrollment ID: I20130708000300 |
| Provider Name | Lori M Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992987598 PECOS PAC ID: 9335467448 Enrollment ID: I20150421000350 |
| Provider Name | Sarah L Fredericks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285924423 PECOS PAC ID: 1052624509 Enrollment ID: I20150714000031 |
| Provider Name | Patricia A Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194126771 PECOS PAC ID: 2668568577 Enrollment ID: I20150925000940 |
| Provider Name | Karen E. Frank |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1023346632 PECOS PAC ID: 0941599831 Enrollment ID: I20160517000285 |
| Provider Name | Edith M. Depeyster |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528191863 PECOS PAC ID: 2062702038 Enrollment ID: I20160602002236 |
| Provider Name | Carol A Lateer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629315528 PECOS PAC ID: 9335433010 Enrollment ID: I20160803000432 |
| Provider Name | Olivia R Honeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215389796 PECOS PAC ID: 2062700859 Enrollment ID: I20161011001685 |
| Provider Name | Alicia M Elwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629421821 PECOS PAC ID: 6002104320 Enrollment ID: I20161019000660 |
| Provider Name | Lee Preston Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649655689 PECOS PAC ID: 8325321599 Enrollment ID: I20170530002428 |
| Provider Name | Joshua Burgess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023418605 PECOS PAC ID: 5193092633 Enrollment ID: I20170605000423 |
| Provider Name | Kayla J Decarr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326481235 PECOS PAC ID: 0547533184 Enrollment ID: I20170905000205 |
| Provider Name | Christina Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770917189 PECOS PAC ID: 4082989082 Enrollment ID: I20171002000012 |
| Provider Name | Charles L Pope |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639473754 PECOS PAC ID: 8729345574 Enrollment ID: I20171201002722 |
| Provider Name | Amber R Barnhart |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538675970 PECOS PAC ID: 5395004592 Enrollment ID: I20180116001373 |
| Provider Name | Jane M Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124452537 PECOS PAC ID: 8527320688 Enrollment ID: I20180329002017 |
| Provider Name | Alison H Franklin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700170974 PECOS PAC ID: 4183979818 Enrollment ID: I20180620001300 |
| Provider Name | Debora Ann Pfluke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669957486 PECOS PAC ID: 2062756091 Enrollment ID: I20181203002013 |
| Provider Name | Veronica Verenich-makayed |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447715917 PECOS PAC ID: 5496094559 Enrollment ID: I20190307000777 |
| Provider Name | Holly E Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255545588 PECOS PAC ID: 5395042881 Enrollment ID: I20220926002232 |
| Provider Name | Trista M Corsino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457086225 PECOS PAC ID: 5698141547 Enrollment ID: I20221018000198 |
| Provider Name | Marissa Martorella |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598122616 PECOS PAC ID: 4880064039 Enrollment ID: I20230104000153 |
| Provider Name | Torie E Hairston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568700201 PECOS PAC ID: 2062891229 Enrollment ID: I20230203001441 |
| Provider Name | Megan E Ayres-gregory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881123834 PECOS PAC ID: 3375900327 Enrollment ID: I20230606002666 |
| Provider Name | Grace M Saxe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588017586 PECOS PAC ID: 8527414515 Enrollment ID: I20231027000153 |
| Provider Name | Ashley R Lallier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770032849 PECOS PAC ID: 3971941337 Enrollment ID: I20240403003980 |
| Provider Name | Angela C Newstrom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437569159 PECOS PAC ID: 3274973185 Enrollment ID: I20240425001889 |
| Provider Name | Sandra L Farnell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841058856 PECOS PAC ID: 3072953892 Enrollment ID: I20240426002416 |
| Provider Name | Kayla E Grippe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083219976 PECOS PAC ID: 5698115194 Enrollment ID: I20240501002099 |
| Provider Name | Cassidy Atkinson-smith |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528770328 PECOS PAC ID: 1759823164 Enrollment ID: I20240612003034 |
| Provider Name | Lisa Smith |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093049389 PECOS PAC ID: 2466994884 Enrollment ID: I20240612003151 |
| Provider Name | Shazia Qaisar Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669205696 PECOS PAC ID: 1557801263 Enrollment ID: I20240909003959 |
| Provider Name | Alexa R Donaruma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578386587 PECOS PAC ID: 6507212610 Enrollment ID: I20241218001205 |
| Provider Name | Gail A Rosenholm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063075430 PECOS PAC ID: 6406378827 Enrollment ID: I20250314001951 |
Kelberman Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2608 Genesee St, Utica, NY 13502 Phone: 315-797-6421 Fax: 315-749-7054 | |
Central Ny Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 286 Genesee St, Utica, NY 13502 Phone: 315-266-0600 Fax: 315-266-0611 | |
Gambling Information And Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Genesee St, Utica, NY 13502 Phone: 315-735-9501 Fax: 315-735-9769 | |
Center For Family Life And Recovery, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Court St, Suite 401, Utica, NY 13502 Phone: 315-733-1709 Fax: 315-733-1789 | |
Sphere Psychological Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2520 Genesee St Fl 2, Utica, NY 13502 Phone: 315-941-5170 Fax: 315-533-4377 | |
Utica Catholic Charities Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1408 Genesee St, Utica, NY 13502 Phone: 315-724-2158 Fax: 315-735-7754 | |
Evolve Counseling, Lcsw, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2316 Genesee St, Utica, NY 13502 Phone: 607-201-5269 |