NPIMap

Organization Active NPI

Psych Consultants Berk-Lehigh

  • Primary Care Nurse Practitioner
  • Mount Carmel, PA
National Provider Identifier
1083090823
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
TP006931C Issued in PA
Legal business name
PSYCH CONSULTANTS BERK-LEHIGH
Practice address
601 W 5TH St
Mount Carmel, PA 17851-1303
Phone
(570) 875-8058
Fax
(570) 554-4357
NPI assigned
Aug 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joan M Cicchiello, PMHNP
Title
Executive Director
Phone
(570) 875-9434

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X TP 006931C PA
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X SP009838 PA
Primary Care Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP2300X TP006931C PA Primary

Addresses

Primary practice location

601 W 5TH St
Mount Carmel, PA 17851-1303

Mailing address

601 W 5TH St
Mount Carmel, PA 17851-1303
Phone (570) 875-8058

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1083090823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 5TH ST",
            "city": "MOUNT CARMEL",
            "state": "PA",
            "postal_code": "178511303",
            "telephone_number": "570-875-8058",
            "fax_number": "570-554-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 5TH ST",
            "city": "MOUNT CARMEL",
            "state": "PA",
            "postal_code": "178511303",
            "telephone_number": "570-875-8058",
            "fax_number": "570-554-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH CONSULTANTS BERK-LEHIGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "CICCHIELLO",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-875-9434",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "TP 006931C",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP009838",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "TP006931C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.