LUZERNE WYOMING COUNTY MH CENTER #1 (NPI# 1578684973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578684973 |
| Entity Type | Organization |
| Organization Name | LUZERNE WYOMING COUNTY MH CENTER #1 |
| Other Organization Name | COMMUNITY COUNSELING SERVICES OF NEPA |
| Practice Address |
562 Wyoming Ave Kingston PA 18704-3721 |
| Practice Telephone | 5705523900 |
| Practice Fax Number | 5705523907 |
| Mailing Telephone | 5705523900 |
| Mailing Fax Number | 5705523907 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-09-12 |
| Authorized Official Name | JOSEPH H KNECHT (CEO) |
| Authorized Official Telephone | 5705523900 |
| Is Organization Subpart | Y |
| Parent Organization Name | LUZERNE WYOMING COUNTY MH CENTER #1 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
22480 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100002080-0036 | 05 |
| Other Name | Type Code |
|---|---|
| Community Counseling Services of NEPA | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568583474 | Luzerne Wyoming County Mh Center #1 | Clinic/Center | R 307 Laird Street, Wilkes-barre, PA 18702 | 2007-04-02 |
| 1700066628 | Luzerne Wyoming County Mh Center #1 | Psychologist | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2007-11-08 |
| 1518147438 | Luzerne Wyoming County Mh Center #1 | Psychiatry & Neurology | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2007-11-08 |
| 1255511176 | Luzerne Wyoming County Mh Center #1 | Psychologist | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2007-11-08 |
| 1609056522 | Luzerne Wyoming County Mh Center #1 | Social Worker | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2007-11-08 |
| 1609056530 | Luzerne Wyoming County Mh Center #1 | Social Worker | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2007-11-08 |
| 1013197953 | Luzerne Wyoming County Mh Center #1 | Psychiatry & Neurology | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2007-11-08 |
| 1558541441 | Luzerne Wyoming County Mh Center #1 | Social Worker | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2007-11-07 |
| 1699896076 | Luzerne Wyoming County Mh Center #1 | Case Management | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2007-04-03 |
| 1609997089 | Luzerne Wyoming County Mh Center #1 | Public Health or Welfare | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2007-04-03 |
| Street Address |
562 WYOMING AVE |
| City | KINGSTON |
| State | PA |
| Zip Code | 18704-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683417 | David Liskov | Psychiatry & Neurology | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2005-07-15 |
| 1376186064 | Brent Smith | Registered Nurse | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2019-10-24 |
| 1275812661 | Roseanne P Pace | Counselor | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2011-08-16 |
| 1609172170 | Brittany Bahner | Counselor | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2011-02-01 |
| 1528368826 | Mary Repasky | Counselor | 562 Wyoming Ave, Choices Program of Wyoming Valley, Kingston, PA 18704 | 2010-11-02 |
| 1073842936 | Wilkes Barre Behavioral Hospital Company LLC | Registered Nurse | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-12-23 |
| 1285862409 | David Liskov, Md | Psychiatry & Neurology | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-25 |
| 1013144211 | Md.mushfiqur Rahman | Psychiatry & Neurology | 562 Wyoming Ave, First Hospital, Kingston, PA 18704-3721 | 2009-06-15 |
| 1114153921 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-08 |
| 1477789287 | Wilkes Barre Behavioral Hospital Company LLC | Case Management | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013557552 | Millmark Health Inc. | Psychiatry & Neurology | 511 Pierce Street, Kingston, PA 18704 | 2020-01-13 |
| 1427550334 | Michael Anthony Waltich | Military Health Care Provider | 82 Cooper Street, Pringle, PA 18704 | 2018-03-06 |
| 1376088435 | Jae LLC | Massage Therapist | 512 Northhampton Street, Edwardsville, PA 18704 | 2016-12-28 |
| 1306278288 | Mohammad Khaled Tashkandi | Internal Medicine | 490 Northampton St Ste 1, Edwardsville, PA 18704 | 2013-08-02 |
| 1396180014 | Sammie Craven IIi | Pharmacist | 96 1st Avenue, Kingston, PA 18704 | 2013-05-08 |
| 1447693114 | Catherine Mary Harding | Nurse Practitioner | 141 South Maple Ave, Kingston, PA 18704 | 2013-04-12 |
| 1861781403 | Jennifer Ann Richards | Pharmacist | 22 West Side Mall, Edwardsville, PA 18704 | 2011-04-05 |
| 1558512772 | Jolon Theresa Sherin | Speech-Language Pathologist | 1825 Sans Souci Highway, Hanover, PA 18704 | 2008-10-07 |
| 1932361102 | Kari Ann Pietralczyk | Audiologist | 190 Welles Street, Forty-fort, PA 18704 | 2008-06-30 |
| 1467584151 | John Christopher Storti | Chiropractor | 180 United Penn Plaza, Kingston, PA 18704 | 2007-03-09 |
| Find all providers in zip 18704 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891335410 | Bayside Counseling and Consulting | Clinic/Center | 40 Cedar Ln, Kingston, MA 02364-1743 | 2020-01-11 |
| 1720157613 | Southern Oklahoma Treatment Services, Inc. | Clinic/Center | 500 North Hwy 70, Kingston, OK 73439 | 2006-11-07 |
| 1447574439 | Amy Elizabeth Gordon | Clinic/Center | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2010-03-18 |
| 1730410515 | Mollie Williams | Clinic/Center | 717b Highway 70 E, Kingston, OK 73439-8253 | 2010-01-19 |
| 1114153921 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-08 |
| 1730325531 | Grunblatt Psychology and Counseling Offices, P.C. | Clinic/Center | 124 Green St, Kingston, NY 12401-4422 | 2008-12-29 |
| 1568631513 | Luzerne Wyoming County Mental Health Center #1 | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2008-02-25 |
| 1285803239 | Luzerne Wyoming County Mental Health Center #1 | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2008-02-25 |
| 1154480051 | Port Gamble S'klallam Mental Health | Clinic/Center | 32014 Little Boston Rd Ne, Kingston, WA 98346-9734 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205437092 | Northeast Counseling Service | Clinic/Center | 109 W Green St, Nanticoke, PA 18634-2212 | 2020-11-06 |
| 1356949663 | Christina Robidoux, Lpc | Clinic/Center | 321 Pine St Ste 207-208, Williamsport, PA 17701-6561 | 2020-10-09 |
| 1447857800 | Simple Healing LLC | Clinic/Center | 11 W 2nd St Unit 305, Bethlehem, PA 18015-1294 | 2020-10-07 |
| 1629683693 | Sunshine Counseling, LLC | Clinic/Center | 1093 Douglass Dr Apt A, Boyertown, PA 19512-7620 | 2020-09-15 |
| 1619582533 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 749 South St, Laporte, PA 18626-7019 | 2020-09-09 |
| 1023623956 | Sunshine Healing & Counseling | Clinic/Center | 328 Summit Ave Ste 120, Jenkintown, PA 19046-3134 | 2020-09-08 |
| 1376153940 | Nami Erie County Pa | Clinic/Center | 1611 Peach St Ste 218, Erie, PA 16501-2121 | 2020-08-07 |
| 1376161919 | Bryan Bass-riley Licensed Professional Counselor, LLC | Clinic/Center | 3825 Northern Pike Ste 202, Monroeville, PA 15146-2161 | 2020-07-09 |
| 1053937664 | Theosis Therapeutic Counseling | Clinic/Center | 982 E Pine St, Palmyra, PA 17078-2821 | 2020-06-19 |
| 1366065633 | Let's Talk Counseling, LLC | Clinic/Center | 510 Springfield Rd, Aldan, PA 19018-4227 | 2020-05-21 |
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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.