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NPI Code Detail

MEDICARE: CHILDREN'S SERVICE CENTER OF WYOMING VALLEY INC

MEDICARE: CHILDREN'S SERVICE CENTER OF WYOMING VALLEY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician100728011PA
2103T00000XPsychologist100728011PA
31041C0700XClinical Social Worker100728011PA
4163WP0807XChild & Adolescent Psychiatric/Mental Health Registered Nurse100728011PA
5101Y00000XCounselor100728011PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700861242
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S SERVICE CENTER OF WYOMING VALLEY INC
Provider Business Mailing Address
First Line : 335 S FRANKLIN ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-3808
Country : US
Telephone Number : 570-825-6425
Fax Number : 570-301-3330
Provider Business Practice Location Address
First Line : 335 S FRANKLIN ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-3808
Country : US
Telephone Number : 570-825-6425
Fax Number : 570-301-3330
Authorized Official
Title or Position : CFO
Name : MRS. SHARON PISARCIK
Credential :
Telephone Number : 570-825-6425
Provider Enumeration Date : 12/07/2005
Last Update Date : 07/28/2020

Similar Medicare Providers

1063895431 — JENNIFER L SCHELL MSN,CRNP
Practice Location Address:
335 S FRANKLIN ST
WILKES BARRE, PA
18702-3808
Practice Phone: 570-301-0924
Practice Fax: 570-505-6224
1437131141 — JOHN THEROUX MD
Practice Location Address:
335 S FRANKLIN ST
WILKES BARRE, PA
18702-3808
Practice Phone: 570-825-6425
Practice Fax: 570-829-3337
1356377428 — DR. MUHAMMAD AKRAM KHAN M.D.
Practice Location Address:
335 S FRANKLIN ST , C/O CHILDREN'S SERVICE CENTER
WILKES BARRE, PA
18702-3808
Practice Phone: 570-825-6425
Practice Fax: 570-829-3337
1225061880 — DR. WITTAWAT KASAYAPANAND M.D.
Practice Location Address:
335 S FRANKLIN ST
WILKES BARRE, PA
18702-3808
Practice Phone: 570-825-6425
Practice Fax: 570-829-3337
1366464117 — MR. JOHN PHILIP GREENBAUM LCSW
Practice Location Address:
335 S FRANKLIN ST
WILKES BARRE, PA
18702-3808
Practice Phone: 570-825-6425
Practice Fax: 570-762-9011
1073641130 — ANITA LOUISE ZABOSKI LSW
Practice Location Address:
335 S FRANKLIN ST
WILKES BARRE, PA
18702-3808
Practice Phone: 570-825-6425
Practice Fax:

Directions to “CHILDREN'S SERVICE CENTER OF WYOMING VALLEY INC ” Practice Location

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