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NPI Code Detail

MEDICARE: CHILDREN'S SERVICE CENTER OF WYOMING VALLEY

MEDICARE: CHILDREN'S SERVICE CENTER OF WYOMING VALLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency1007280110006PA
2261QM0855XAdolescent and Children Mental Health Clinic/Center1007280110006PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821218199
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S SERVICE CENTER OF WYOMING VALLEY
Provider Business Mailing Address
First Line : 335 S FRANKLIN ST BLDG C
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-3808
Country : US
Telephone Number : 570-825-6425
Fax Number :
Provider Business Practice Location Address
First Line : 335 S FRANKLIN ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-3808
Country : US
Telephone Number : 570-825-6425
Fax Number :
Authorized Official
Title or Position : CFO
Name : MR. SHARON VIVIAN
Credential :
Telephone Number : 570-825-6425
Provider Enumeration Date : 04/27/2007
Last Update Date : 06/15/2026

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1750213898 — MS. AMANDA MARIE THOMPSON LMSW
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Directions to “CHILDREN'S SERVICE CENTER OF WYOMING VALLEY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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