Provider Demographics
NPI:1811508096
Name:FAMILY SERVICES OF CHEMUNG COUNTY
Entity type:Organization
Organization Name:FAMILY SERVICES OF CHEMUNG COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NIA
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:BEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:607-733-5696
Mailing Address - Street 1:2701 YALE ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3254
Mailing Address - Country:US
Mailing Address - Phone:347-322-3777
Mailing Address - Fax:
Practice Address - Street 1:1019 E WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3332
Practice Address - Country:US
Practice Address - Phone:607-733-5696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty