1. Home
  2. Directory
  3. New York
  4. Wampsville
  5. Clinic Center
  6. NPI Profile

MADISON COUNTY MENTAL HEALTH DEPARTMENT OUTPATIENT CLINIC
NPI 1689780546
Clinic/Center - Mental Health (Including Community Mental Health Center) in Wampsville, NY

Active since August 22, 2006CLIA 33D2300471 · Waiver
138 NORTH COURT STREET, WAMPSVILLE, NY 13163(315) 366-2327(315) 366-2599 Get Directions Write a Review

NPPES record last updated: December 6, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Madison County Mental Health Department Outpatient Clinic NPPES

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

MADISON COUNTY MENTAL HEALTH DEPARTMENT OUTPATIENT CLINIC (NPI 1689780546) is a healthcare organization registered as a mental health (including community mental health center) in Wampsville, New York and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Teisha M Cook, Director, as its authorized official.

NPPES Registry Identity

NPI1689780546
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameMADISON COUNTY
Location Address138 NORTH COURT STREETWampsville, NY 13163-0608
Mailing Address138 North Court StreetWampsville, NY 13163-0608 · (315) 366-2327 · Fax (315) 366-2599
Phone(315) 366-2327
Fax(315) 366-2599
Organization SubpartNo
Authorized OfficialTeisha M CookDirector · (315) 366-2327
Enumeration DateAugust 22, 2006
Last NPPES UpdateDecember 6, 2019
✔ NPI 1689780546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
License✔ Licensed in NY · 6873100A
138 NORTH COURT STREET, Wampsville, NY 13163
Open in Google Maps ↗

Other Names 1

Other NameMadison County Mental Health Department Outpatient Clinic

Other Identifiers 2

Medicaid00569860NY
Medicaid03004400NY

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 33D2300471

Madison County Mental Health · Wampsville, NY
Active · expires Mar 26, 2027
CLIA Number33D2300471
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 12, 2024
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorErika L. Demarche
Laboratory Phone(315) 366-2327
Laboratory LocationMadison County Mental Health138 N Court St - Bldg 2, Wampsville, NY 13163
CLIA data matches this NPI record on: Address Name Phone
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.

STEPHANIE ANN THOMPSON
Social Worker (Clinical)
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MS. ALEXA BRAYMAN LMSW
Social Worker
138 NORTH COURT STREET, #7
WAMPSVILLE, NY 13163
Madison County (315) 366-2435
MISS ELENI KARAYIANNI M.A.
Counselor (Mental Health)
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
RUSSELL JAMES STEWART
Counselor (Addiction (Substance Use Disorder))
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
DR. SHANNON K BIRMINGHAM PSY D
Psychologist
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MR. GARY ROY ROBERTS CASAC
Counselor (Addiction (Substance Use Disorder))
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MRS. STEPHANIE ANN ANDERSON LCSW
Social Worker
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
AMINTHA M. SELVARAJAH PA-C
Physician Assistant
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327

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 Madison County's NPI number?

The NPI number for Madison County is 1689780546. It was assigned to this organization in the NPPES registry on August 22, 2006. The provider is also known as Madison County Mental Health Department Outpatient Clinic.

Where is Madison County located?

Madison County is located at 138 North Court Street, Wampsville, NY 13163. The listed phone number is (315) 366-2327.

What is Madison County's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Madison County hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2300471) 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 Madison County was last updated on December 6, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.