Provider Demographics
NPI:1104669142
Name:COUNTY OF ERIE, NEW YORK
Entity type:Organization
Organization Name:COUNTY OF ERIE, NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER OF MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:716-858-8531
Mailing Address - Street 1:95 FRANKLIN ST. ROOM 1237
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202
Mailing Address - Country:US
Mailing Address - Phone:716-858-6381
Mailing Address - Fax:
Practice Address - Street 1:95 FRANKLIN ST. ROOM 1237
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202
Practice Address - Country:US
Practice Address - Phone:716-858-6381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ERIE NY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health