Healthcare Provider Details

I. General information

NPI: 1710910310
Provider Name (Legal Business Name): BEAVER COUNTY PSYCHIATRIC SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 THIRD STREET
BEAVER PA
15009
US

IV. Provider business mailing address

219 THIRD STREET
BEAVER PA
15009
US

V. Phone/Fax

Practice location:
  • Phone: 724-775-9150
  • Fax: 724-775-9153
Mailing address:
  • Phone: 724-775-9150
  • Fax: 724-775-9153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUZANNE E VOGEL-SCIBILIA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 724-775-9150