Healthcare Provider Details

I. General information

NPI: 1720741135
Provider Name (Legal Business Name): CEIL BARTOLAI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CEIL SCAETNA

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N BLAKELY ST
DUNMORE PA
18512-1904
US

IV. Provider business mailing address

7 CHESTNUT ST
HUGHESTOWN PA
18640-3625
US

V. Phone/Fax

Practice location:
  • Phone: 570-780-4505
  • Fax:
Mailing address:
  • Phone: 570-237-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017659
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: