Provider Demographics
NPI:1306479555
Name:SOUTHERNTIER MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:SOUTHERNTIER MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:315-402-4417
Mailing Address - Street 1:1635 UNION CENTER MAINE HWY
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1340
Mailing Address - Country:US
Mailing Address - Phone:607-239-5766
Mailing Address - Fax:607-239-5857
Practice Address - Street 1:1635 UNION CENTER MAINE HWY
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-1340
Practice Address - Country:US
Practice Address - Phone:607-239-5766
Practice Address - Fax:607-239-5857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)