NPIMap

Organization Active NPI

Luzerne Wyoming Counties Mental Health Mental Retardation Program

  • Case Manager/Care Coordinator
  • Wilkes Barre, PA
National Provider Identifier
1154455061
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
LUZERNE WYOMING COUNTIES MENTAL HEALTH MENTAL RETARDATION PROGRAM
Practice address
111 N Pennsylvania Ave
Suite 200
Wilkes Barre, PA 18701-3511
Phone
(570) 831-7277
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Authorized official

Name
Mrs. Antoinette Cisowski
Title
MH Mr Administrator
Phone
(570) 825-9441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

111 N Pennsylvania Ave
Suite 200
Wilkes Barre, PA 18701-3511

Mailing address

200 N River Street
Treasurer Luzerne County
Wilkes Barre, PA 18711-1001

National Provider Directory

National Provider Directory
Tax ID family
Luzerne Wyoming Counties Mental Health Mental Retardation Program5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1154455061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N RIVER STREET",
            "address_2": "TREASURER LUZERNE COUNTY",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187111001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PENNSYLVANIA AVE",
            "address_2": "SUITE 200",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013511",
            "telephone_number": "570-831-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZERNE WYOMING COUNTIES MENTAL HEALTH MENTAL RETARDATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "CISOWSKI",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "MH MR ADMINISTRATOR",
        "authorized_official_telephone_number": "570-825-9441",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.