Healthcare Provider Details

I. General information

NPI: 1841131349
Provider Name (Legal Business Name): CORE PSYCHIATRIC & PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 CHESTNUT AVE
DU BOIS PA
15801-2988
US

IV. Provider business mailing address

PO BOX 19
GRAMPIAN PA
16838-0019
US

V. Phone/Fax

Practice location:
  • Phone: 814-371-1088
  • Fax: 814-371-4966
Mailing address:
  • Phone: 814-849-2844
  • Fax: 814-849-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEMMA NOELLE BROOKS
Title or Position: OUTPATIENT THERAPIST
Credential: LPC
Phone: 814-913-4755