COMMONWEALTH CLINICAL GROUP, INC. (NPI# 1215558382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215558382 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH CLINICAL GROUP, INC. |
| Practice Address |
41 E Orange St Lancaster PA 17602-2846 |
| Practice Telephone | 7173933900 |
| Practice Fax Number | 7173937900 |
| Mailing Telephone | 7173933900 |
| Mailing Fax Number | 7173937900 |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-05-08 |
| Authorized Official Name | JUDY KILE (BILLING COORDINATOR) |
| Authorized Official Telephone | 7173933900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 336180 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184278509 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 1 E Market St Ste 402, York, PA 17401-1611 | 2019-07-25 |
| 1144465899 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 2444 N 3rd St, Harrisburg, PA 17110-1901 | 2008-12-10 |
| 1437394186 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 1 E Market St Ste 104, York, PA 17401-1618 | 2008-12-10 |
| 1023267473 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 41 E Orange St, Lancaster, PA 17602-2846 | 2008-09-10 |
| 1144845231 | Commonwealth Clinical Group, Inc. | Clinic/Center | 450 S 5th St, Reading, PA 19602-2642 | 2020-06-15 |
| 1013530898 | Commonwealth Clinical Group, Inc. | Clinic/Center | 479 Thomas Jones Way Ste 100, Exton, PA 19341-2585 | 2020-05-27 |
| 1750706198 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 479 Thomas Jones Way, Suite 100, Exton, PA 19341-2580 | 2014-02-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMONWEALTH CLINICAL GROUP, INC. | 41 E Orange St, Lancaster, PA 17602-2846 |
| Street Address |
41 E ORANGE ST |
| City | LANCASTER |
| State | PA |
| Zip Code | 17602-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023267473 | Commonwealth Clinical Group, Inc. | Community/Behavioral Health | 41 E Orange St, Lancaster, PA 17602-2846 | 2008-09-10 |
| 1609474246 | Kayla Weiler | Social Worker | 41 E Orange St, Lancaster, PA 17602-2846 | 2020-10-15 |
| 1124592415 | Patricia Stough | Social Worker | 41 E Orange St, Lancaster, PA 17602-2846 | 2019-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313173 | Taylor Giambrone | Registered Nurse | Lgh Nurse Family Partnership, 555 North Duke Street, Lancaster, PA 17602 | 2020-10-12 |
| 1982268843 | Blanche Nichole Breznak | Pharmacist | 201 East Chestnut St, Lancaster, PA 17602 | 2019-04-25 |
| 1285104851 | Stephanie Benedict | Pharmacist | 1603 Lincoln Highway East, Lancaster, PA 17602 | 2018-11-27 |
| 1043709835 | Deborah J Campos-bard, Lmt | Massage Therapist | 439 N. Duke St. 2nd Fl., 2, Lancaster, PA 17602 | 2018-05-07 |
| 1861989493 | Functional Freedom LLC | Occupational Therapist | 105 Heritage Rd., Lancaster, PA 17602 | 2018-04-19 |
| 1083094577 | Gracie Berry | Counselor | 413 Church St, Lancaster, PA 17602 | 2015-06-01 |
| 1366835597 | Holcomb Associates, Inc. | Community/Behavioral Health | 800 New Holland Avenue, Lancaster, PA 17602 | 2015-03-12 |
| 1205236965 | Maria Taylor | Physician Assistant | 555 N Duke Street, Lghp Hospitalists, Lancaster, PA 17602 | 2014-09-01 |
| 1114355104 | Charles Eugene Stream | Physician Assistant | 133 East Fredeick Street, Lancaster, PA 17602 | 2013-10-29 |
| 1710221668 | Kourtney Randsdorp | Occupational Therapist | 105 Heritage Rd, Lancaster, PA 17602 | 2012-11-15 |
| Find all providers in zip 17602 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.