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General NPI Number Information
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NPI Number | 1841289733
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Entity Type | Organization
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Legal Business Name | CEN CLEAR CHILD SERVICES, INC.
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 1633 PHILIPSBURG BIGLER HWY
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City | PHILIPSBURG
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State | PA
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Zip | 16866-8112
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Country | US
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Telephone | 814-342-5678
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Fax | 814-342-2755
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Provider Business Mailing Address
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Address Line | PO BOX 319 50 BIGLER ROAD
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City | BIGLER
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State | PA
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Zip | 16825-0319
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Country | US
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Telephone | 814-342-5678
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Fax | 814-342-2755
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Authorized Official
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Title or Position | CEO
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Name | MRS. PAULINE RAAB
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Credential |
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Telephone | 814-342-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 406200
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 406200
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 406200
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 406200
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 406200
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License Number State | PA
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