Provider Demographics
NPI:1699727941
Name:FAMILY SERVICES OF WESTCHESTER, INC.
Entity type:Organization
Organization Name:FAMILY SERVICES OF WESTCHESTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-937-2320
Mailing Address - Street 1:ONE GATEWAY PLAZA
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4674
Mailing Address - Country:US
Mailing Address - Phone:914-937-2320
Mailing Address - Fax:913-937-4452
Practice Address - Street 1:ONE GATEWAY PLAZA
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4674
Practice Address - Country:US
Practice Address - Phone:914-937-2320
Practice Address - Fax:913-937-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0081L001251E00000X
251S00000X, 261QA0600X
NY6152100A261QM0801X
NY6152100B261QM0801X
NY6152100C261QM0801X
NY6152100D261QM0801X
NY6152110A261QM0801X
NY6152110B261QM0801X
NY6152110C261QM0801X
NY6152110D261QM0801X
NY6152110E261QM0801X
NY6152430320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01405807Medicaid
NY00868635Medicaid
NY01405807Medicaid