NPIMap

Organization Active NPI

Colonial Intermediate Unit 20

  • Adolescent and Children Mental Health Clinic/Center
  • Stroudsburg, PA
National Provider Identifier
1083736367
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
235100 Issued in PA
Legal business name
COLONIAL INTERMEDIATE UNIT 20
Practice address
1110 W Main St
Stroudsburg High School
Stroudsburg, PA 18360-1397
Phone
(610) 515-6477
Fax
(610) 515-6457
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Dr. Christopher Wolfel, D. ED
Title
Executive Director
Phone
(610) 252-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 235100 PA Primary

Addresses

Primary practice location

1110 W Main St
Stroudsburg High School
Stroudsburg, PA 18360-1397

Mailing address

6 Danforth Dr
Easton, PA 18045-7899
Phone (610) 252-5550

Other identifiers 2

IdentifierTypeStateIssuer
1083736367OtherNPI
1007544600027MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Colonial Intermediate Unit 2044 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1083736367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DANFORTH DR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180457899",
            "telephone_number": "610-252-5550",
            "fax_number": "610-515-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W MAIN ST",
            "address_2": "STROUDSBURG HIGH SCHOOL",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601397",
            "telephone_number": "610-515-6477",
            "fax_number": "610-515-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL INTERMEDIATE UNIT 20",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "WOLFEL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-252-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. ED"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "235100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083736367",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007544600027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.