Healthcare Provider Details

I. General information

NPI: 1063552537
Provider Name (Legal Business Name): NORTHEAST COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W WASHINGTON ST
NANTICOKE PA
18634-3113
US

IV. Provider business mailing address

750 E BROAD ST
HAZLETON PA
18201-6835
US

V. Phone/Fax

Practice location:
  • Phone: 570-735-7590
  • Fax:
Mailing address:
  • Phone: 570-455-6385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1007615710023
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number1007615710023
License Number StatePA

VIII. Authorized Official

Name: MR. ED ABDO JR.
Title or Position: EXEC DIRECTOR
Credential:
Phone: 570-455-6385