NPIMap

Organization Active NPI

Children's Center for Treatment and Education

Doing business as Beacon Light Behavioral Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, PA
National Provider Identifier
1366609646
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CHILDREN'S CENTER FOR TREATMENT AND EDUCATION
Doing business as
Beacon Light Behavioral Health System
Beacon Light Behavioral Health Systems
Practice address
1885 Market St
Warren, PA 16365-1227
Phone
(814) 817-1400
Fax
(814) 817-1447
NPI assigned
May 22, 2008
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S HOME OF BRADFORDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Mrs. Susan R Teconchuk
Title
Contract Manager
Phone
(814) 817-1400

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1885 Market St
Warren, PA 16365-1227

Mailing address

800 E Main St
Bradford, PA 16701-3278
Phone (814) 817-1400

Other names 2

  • Beacon Light Behavioral Health System Doing business as
  • Beacon Light Behavioral Health Systems Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090312000564 PA Part B Supplier - Clinic/Group Practice 4880750017 Receives reassigned benefits from 21 practitioners
1 other NPI on this enrollment
Practice locations: Bradford, PA; Tionesta, PA; Warren, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1366609646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167013278",
            "telephone_number": "814-817-1400",
            "fax_number": "814-817-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 MARKET ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651227",
            "telephone_number": "814-817-1400",
            "fax_number": "814-817-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CENTER FOR TREATMENT AND EDUCATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S HOME OF BRADFORD",
        "enumeration_date": "2008-05-22",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "TECONCHUK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "814-817-1400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Light Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Light Behavioral Health Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Light Behavioral Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.