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CONIFER PARK, INC.
NPI 1346296720
Clinic/Center - Rehabilitation, Substance Use Disorder in Plattsburgh, NY

Active since May 26, 2006CLIA 33D2028445 · Waiver
80 SHARRON AVE, PLATTSBURGH, NY 12901(518) 561-1447(518) 562-8812 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 29, 2021, Jan 30, 2017 (2 updates tracked since 2017).

About Conifer Park, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONIFER PARK, INC. (NPI 1346296720) is a healthcare organization registered as a rehabilitation, substance use disorder in Plattsburgh, New York and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Tammy Smith, Director, Op Billing Dept., as its authorized official.

NPPES Registry Identity

NPI1346296720
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameCONIFER PARK, INC.
Location Address80 SHARRON AVEPlattsburgh, NY 12901-4700
Mailing AddressPo Box 10092Albany, NY 12201-5092 · (518) 952-8408 · Fax (518) 399-6860
Phone(518) 561-1447
Fax(518) 562-8812
Organization SubpartNo
Authorized OfficialTammy SmithDirector, Op Billing Dept. · (518) 952-8408
Enumeration DateMay 26, 2006
Last NPPES UpdateApril 29, 20212 updates tracked since enumeration
NPPES CertifiedApril 29, 2021
✔ NPI 1346296720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
80 SHARRON AVE, Plattsburgh, NY 12901
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Other Identifiers 1

Medicaid01420800NY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2028445

Conifer Park - Plattsburgh Opc · Plattsburgh, NY
Active · expires Mar 26, 2027
CLIA Number33D2028445
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateAugust 17, 2011
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. George A. Disney
Laboratory Phone(518) 561-0130
Laboratory LocationConifer Park - Plattsburgh Opc80 Sharron Avenue, Plattsburgh, NY 12901
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATRINA LOPEZ
Peer Specialist
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
JARED CROY CIT
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
CORY RYAN
Peer Specialist
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
PATRICK MCCORMICK CASC-T
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
STEPHEN GALIETTA CASAC
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 952-8140
JAMES FACTEAU
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
LISA SEARS-BOWLEN
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447
ELIZABETH MANOR
Counselor (Addiction (Substance Use Disorder))
80 SHARRON AVE
PLATTSBURGH, NY 12901
Clinton County (518) 561-1447

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conifer Park, Inc.'s NPI number?

The NPI number for Conifer Park, Inc. is 1346296720. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Conifer Park, Inc. located?

Conifer Park, Inc. is located at 80 Sharron Ave, Plattsburgh, NY 12901. The listed phone number is (518) 561-1447.

What is Conifer Park, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does Conifer Park, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2028445) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Conifer Park, Inc. was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.