Basic Information
| Provider Information | |||||||||
| NPI: | 1922171305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARSONS CHILD AND FAMILY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184262600 | ||||||||
| FaxNumber: | 5184471812 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184262600 | ||||||||
| FaxNumber: | 5184471812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 03/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | ROSSETTI | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | ROBERT | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OF BEHAVIORAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 5185885922 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW-R | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 251S00000X | N | Agencies | Community/Behavioral Health | 261QM0801X | 6223100A | NY | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 323P00000X | N | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | 311Z00000X | Y | Nursing & Custodial Care Facilities | Custodial Care Facility |
ID Information
| ID | Type | State | Issuer | Description | 00353195 | 05 | NY | MEDICAID | 02065534 | 05 | NY | MEDICAID | 02923531 | 05 | NY | MEDICAID | 02679156 | 05 | NY | MEDICAID | 00555793 | 05 | NY | MEDICAID | 00832031 | 05 | NY | MEDICAID |