ST. LUKE'S PHYSICIAN GROUP, INC. (NPI# 1922633783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922633783 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Practice Address |
1170 Fernwood St Bethlehem PA 18018-3016 |
| Mailing Address |
77 S Commerce Way Bethlehem PA 18017-8891 |
| Practice Telephone | 4845268046 |
| Mailing Telephone | 4845268046 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | SUE CHIAVAROLI (CVO ENROLLMENT SUPERVISOR) |
| Authorized Official Telephone | 4845263569 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. LUKE'S PHYSICIAN GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| St. Luke's Psychiatric Assoc. - Bethlehem ASD Northeast Middle School | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645518 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 723 Coal St, Easton, PA 18042-6556 | 2020-09-30 |
| 1093322380 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 990 Echo Trl, Easton, PA 18040-1014 | 2020-09-30 |
| 1720695141 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 429 Reeder St, Easton, PA 18042-1731 | 2020-09-29 |
| 1710594130 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1709 Richmond Rd, Easton, PA 18040-8435 | 2020-09-29 |
| 1528675345 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1315 Echo Trl, Easton, PA 18040-1019 | 2020-09-25 |
| 1164039996 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1243 Tatamy Rd, Easton, PA 18045-7405 | 2020-09-25 |
| 1578170304 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1221 Northampton St, Easton, PA 18042-4138 | 2020-09-25 |
| 1144834649 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 257 Brodhead Rd, Bethlehem, PA 18017-8938 | 2020-09-02 |
| 1689288110 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1021 Calypso Ave, Bethlehem, PA 18018-5005 | 2020-09-02 |
| 1962016477 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1621 Catasauqua Rd, Bethlehem, PA 18017-7407 | 2020-09-02 |
| Street Address |
1170 FERNWOOD ST |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018-3016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
| Find all providers in zip 18018 | ||||
| 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 |
|---|---|---|---|---|
| 1447857800 | Simple Healing LLC | Clinic/Center | 11 W 2nd St Unit 305, Bethlehem, PA 18015-1294 | 2020-10-07 |
| 1568013621 | Bright Solutions Counseling | Clinic/Center | 35 E Elizabeth Ave Ste 29c, Bethlehem, PA 18018-6505 | 2019-09-20 |
| 1568931087 | Btg Counseling and Educational Services, LLC. | Clinic/Center | 60 W Broad St Ste 202, Bethlehem, PA 18018-5721 | 2018-11-14 |
| 1922277946 | Bet-el Counseling Services, Inc | Clinic/Center | 307 E 4th St, Bethlehem, PA 18015-1775 | 2008-02-23 |
| 1760455596 | Lehighvalley Community Mental Health Centers, Inc. | Clinic/Center | 865 E 4th St, Bethlehem, PA 18015-1935 | 2006-02-10 |
| 1144860727 | Phoenix Rising Life Coaching Services, LLC | Clinic/Center | 35 E Elizabeth Ave Ste 6, Bethlehem, PA 18018-6505 | 2020-01-10 |
| 1053838813 | Holistic Awakenings | Clinic/Center | 206 W Broad St, Bethlehem, PA 18018-5571 | 2017-08-23 |
| 1225499643 | Changing Life Counseling Center | Clinic/Center | 865 E 4th St, Bethlehem, PA 18015-1935 | 2016-03-11 |
| 1629441860 | Allison Branche | Clinic/Center | 90 S Commerce Way, Bethlehem, PA 18017 | 2015-11-10 |
| 1366815664 | Timothy Minarovic | Clinic/Center | 90 S Commerce Way, Suite 300, Bethlehem, PA 18017-8601 | 2015-11-09 |
| Find all providers in BETHLEHEM | ||||
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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.