Healthcare Provider Details

I. General information

NPI: 1013047778
Provider Name (Legal Business Name): MERCER COUNTY BEHAVIORAL HEALTH COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8406 SHARON MERCER RD
MERCER PA
16137-3138
US

IV. Provider business mailing address

8406 SHARON MERCER RD
MERCER PA
16137-3138
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-1550
  • Fax: 724-662-1557
Mailing address:
  • Phone: 724-662-1550
  • Fax: 724-662-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1000076770004
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1000076770006
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number1000076770010
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1000076770003
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1000076770009
License Number StatePA

VIII. Authorized Official

Name: MR. ROBERT E BILLINGSLEY JR.
Title or Position: IT DIRECTOR
Credential:
Phone: 724-662-1550