NPIMap

Organization Active NPI

Poconos Center for Psychological Services

  • Psychologist
  • Lakeville, PA
National Provider Identifier
1184617631
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
POCONOS CENTER FOR PSYCHOLOGICAL SERVICES
Practice address
1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone
(570) 226-1963
Fax
(570) 226-1967
NPI assigned
Aug 30, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sandra L Burns, PHDNPI 1407840036
Title
Clinical Director/PCPS
Phone
(570) 226-6499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1258 Purdytown Tpke
Lakeville, PA 18438-6793

Mailing address

1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone (570) 226-1963

Other identifiers 1

IdentifierTypeStateIssuer
1012087310001MedicaidPA

Other names 1

  • PCPS Other name

National Provider Directory

National Provider Directory

Locations

1258 Purdytown Tpke
Lakeville, PA 18438
Phone (570) 226-1963

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184617631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-226-1963",
            "fax_number": "570-226-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-226-1963",
            "fax_number": "570-226-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONOS CENTER FOR PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/PCPS",
        "authorized_official_telephone_number": "570-226-6499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012087310001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCPS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.