Active NPI
Mary Christine Remick, M.A., BCBA
- Cognitive & Behavioral Psychologist
- Clarks Summit, PA
National Provider Identifier
1174533806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PS006978L
- Practice address
- 421 S State St
Clarks Summit, PA 18411-1684 - Phone
- (570) 319-6965
- Fax
- (570) 319-6966
- NPI assigned
- Aug 8, 2006
- Last updated
- May 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PS006978L | PA | Primary |
| Behavior Analyst | 103K00000X | #1-07-3652 | PA |
Addresses
Primary practice location
421 S State St
Clarks Summit, PA 18411-1684
Mailing address
RR 4 Box 35a
Dalton, PA 18414-9610
Phone (570) 563-2199
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| #1-07-3652 | Other | PA | BEHAVIOR ANALYTIC CERTIFICATION BOARD |
| PS006978L | Other | PA | PSYCHOLOGIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary C. Remick M.a.,Bcba | Cognitive & Behavioral | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Cognitive & Behavioral Psychologist
- Clarks Summit, PA
- NPI 1548502180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368748800000",
"number": "1174533806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 4 BOX 35A",
"city": "DALTON",
"state": "PA",
"postal_code": "184149610",
"telephone_number": "570-563-2199",
"fax_number": "570-563-2199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 S STATE ST",
"city": "CLARKS SUMMIT",
"state": "PA",
"postal_code": "184111684",
"telephone_number": "570-319-6965",
"fax_number": "570-319-6966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REMICK",
"first_name": "MARY",
"middle_name": "CHRISTINE",
"credential": "M.A., BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2013-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "PA",
"license": "PS006978L",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "#1-07-3652",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYTIC CERTIFICATION BOARD",
"identifier": "#1-07-3652",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "PS006978L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarks Summit, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.