NPIMap

Organization Active NPI

Commonwealth Clinical Group, Inc.

  • Community/Behavioral Health Agency
  • Harrisburg, PA
National Provider Identifier
1306411210
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMONWEALTH CLINICAL GROUP, INC.
Practice address
519 S 29TH St
Harrisburg, PA 17104-2106
Phone
(717) 393-3900
Fax
(717) 393-7900
NPI assigned
May 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Stacie Basham
Title
Billing Coordinator
Phone
(177) 393-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

519 S 29TH St
Harrisburg, PA 17104-2106

Mailing address

41 E Orange St
Lancaster, PA 17602-2846
Phone (717) 393-3900

Other identifiers 1

IdentifierTypeStateIssuer
333660MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address central.referral@ccgtherapy.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Clinical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1306411210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E ORANGE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022846",
            "telephone_number": "717-393-3900",
            "fax_number": "717-393-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 S 29TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171042106",
            "telephone_number": "717-393-3900",
            "fax_number": "717-393-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH CLINICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "BASHAM",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "177-393-3900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333660",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "central.referral@ccgtherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "41 E Orange St",
            "city": "Lancaster",
            "state": "PA",
            "country_code": "US",
            "postal_code": "176022846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.