Provider Demographics
NPI:1992916738
Name:INTERACT, INC.
Entity type:Organization
Organization Name:INTERACT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CHARLETON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:585-388-8010
Mailing Address - Street 1:2136 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1736
Mailing Address - Country:US
Mailing Address - Phone:585-388-8010
Mailing Address - Fax:585-388-8011
Practice Address - Street 1:2136 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1736
Practice Address - Country:US
Practice Address - Phone:585-388-8010
Practice Address - Fax:585-388-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049021-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty