Provider Demographics
NPI:1124099700
Name:TIOGA COUNTY
Entity type:Organization
Organization Name:TIOGA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMUNITY SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:607-687-0200
Mailing Address - Street 1:1062 STATE ROUTE 38
Mailing Address - Street 2:PO BOX 177
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-3209
Mailing Address - Country:US
Mailing Address - Phone:607-687-0200
Mailing Address - Fax:607-687-0248
Practice Address - Street 1:1062 STATE ROUTE 38
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-3209
Practice Address - Country:US
Practice Address - Phone:607-687-0200
Practice Address - Fax:607-687-0248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIOGA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-31
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X, 363L00000X, 363LP0808X
NY6893100A/B1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00618162Medicaid
NY6893100BOtherNYSOMH OPERATING CERT.
NY6893100AOtherNYSOMH OPERATING CERT.
NY00618162Medicaid