NPIMap

Organization Active NPI

Cmsu Behavioral Health and Developmental Services

  • Community/Behavioral Health Agency
  • Bloomsburg, PA
National Provider Identifier
1396069332
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
327770 Issued in PA
Legal business name
CMSU BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
Practice address
675 Locust St
Bloomsburg, PA 17815
Phone
(570) 784-7804
Fax
(570) 784-8307
NPI assigned
Mar 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Authorized official

Name
Mr. Richard D. Beach, LCSW, BCD
Title
Administrator
Phone
(570) 275-5422

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 327770 PA Primary
Community/Behavioral Health Agency 251S00000X 32777 PA
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

675 Locust St
Bloomsburg, PA 17815

Mailing address

PO Box 219
Danville, PA 17821-0219
Phone (570) 275-5422

Other practice location 1

848 Sale Barn Rd
Middleburg, PA 17842-9091
Phone (570) 765-7167

Other practice location 2

194 Fester Rd
Bloomsburg, PA 17815-7238
Phone (570) 204-0132

Other identifiers 2

IdentifierTypeStateIssuer
335290MedicaidPA
1000020900077MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL wwww.cmsu.org Other

National Provider Directory

National Provider Directory
Tax ID family
Cmsu Behavioral Health and Developmental Services9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

675 Locust St
Bloomsburg, PA 17815
Phone (570) 784-7804

5 Terrace Ln
Danville, PA 17821

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1396069332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178210219",
            "telephone_number": "570-275-5422",
            "fax_number": "570-275-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 LOCUST ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "17815",
            "telephone_number": "570-784-7804",
            "fax_number": "570-784-8307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Sale Barn Rd",
            "address_purpose": "LOCATION",
            "city": "Middleburg",
            "state": "PA",
            "postal_code": "178429091",
            "country_code": "US",
            "telephone_number": "570-765-7167",
            "fax_number": "570-765-7168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 Fester Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomsburg",
            "state": "PA",
            "postal_code": "178157238",
            "country_code": "US",
            "telephone_number": "570-204-0132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CMSU BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "BEACH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-275-5422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, BCD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "327770",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "32777",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335290",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000020900077",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wwww.cmsu.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "contact",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phone",
            "address_1": "5 Terrace Ln",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178212202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.