Healthcare Provider Details

I. General information

NPI: 1225125479
Provider Name (Legal Business Name): COMMONWEALTH AFFILIATED SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 FOREST HILLS DR SUITE 38
HARRISBURG PA
17112-1099
US

IV. Provider business mailing address

2215 FOREST HILLS DR SUITE 38
HARRISBURG PA
17112-1099
US

V. Phone/Fax

Practice location:
  • Phone: 717-540-5353
  • Fax: 717-540-5151
Mailing address:
  • Phone: 717-540-5353
  • Fax: 717-540-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC000112
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS003544L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS007421L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS005345L
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW001341L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW003986L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD039464E
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD039381E
License Number StatePA
# 9
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD020877E
License Number StatePA

VIII. Authorized Official

Name: ROGER J CADIEUX
Title or Position: PRESIDENT
Credential: M.D.
Phone: 717-540-5353