Healthcare Provider Details

I. General information

NPI: 1881501641
Provider Name (Legal Business Name): CROYLE-NIELSEN CLINICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 MAIN ST
JOHNSTOWN PA
15901-1509
US

IV. Provider business mailing address

216 MAIN ST
JOHNSTOWN PA
15901-1509
US

V. Phone/Fax

Practice location:
  • Phone: 814-266-2244
  • Fax: 814-254-4691
Mailing address:
  • Phone: 814-266-2244
  • Fax: 814-254-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JESPER P NIELSEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 814-266-2244