NPIMap

Organization Active NPI

Clearfield Jefferson CMHC

  • Clinical Psychologist
  • Du Bois, PA
National Provider Identifier
1144492158
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CLEARFIELD JEFFERSON CMHC
Practice address
100 Caldwell Dr
Du Bois, PA 15801-1152
Phone
(724) 465-5576
Fax
(724) 465-6379
NPI assigned
Mar 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Heather Albright
Title
Billing Supervisor
Phone
(724) 465-5576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

100 Caldwell Dr
Du Bois, PA 15801-1152

Mailing address

793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone (724) 465-5576

Other identifiers 1

IdentifierTypeStateIssuer
1824877OtherPABLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Clearfield-Jefferson CMHC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1144492158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 OLD ROUTE 119 HWY N",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011372",
            "telephone_number": "724-465-5576",
            "fax_number": "724-465-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CALDWELL DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011152",
            "telephone_number": "724-465-5576",
            "fax_number": "724-465-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARFIELD JEFFERSON CMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "ALBRIGHT",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "724-465-5576"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1824877",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.