NPIMap

Organization Active NPI

Millcreek Community Hospital

Doing business as LECOM Institute for Behavioral Health-West Grandview

  • Psychiatry Physician
  • Erie, PA
National Provider Identifier
1396692422
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MILLCREEK COMMUNITY HOSPITAL
Doing business as
LECOM Institute for Behavioral Health-West Grandview
Practice address
2222 W Grandview Blvd
Erie, PA 16506-4508
Phone
(814) 454-3174
Fax
(814) 616-8002
NPI assigned
Mar 16, 2026
Last updated
Mar 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLCREEK COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Jean Nejman
Title
Credentialing Specialist
Phone
(814) 868-2507

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Mental Health Counselor 101YM0800X NU
Psychiatry Physician 2084P0800X NU Primary
Child & Adolescent Psychiatry Physician 2084P0804X NU

Addresses

Primary practice location

2222 W Grandview Blvd
Erie, PA 16506-4508

Mailing address

5515 Peach St
Erie, PA 16509-2603
Phone (814) 864-4031

Other names 1

  • LECOM Institute for Behavioral Health-West Grandview Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260330001211 PA Part B Supplier - Hospital Department(S) 8426020173 Receives reassigned benefits from 17 practitioners
Practice locations: Erie, PA

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Southeast Med Ctr Millc34 organizations share this tax ID, including this one
Part of
Southeast Med Ctr Millc

Other organizations with this tax ID 33

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

View all 33

Locations

2222 W Grandview Blvd
Erie, PA 16506
Phone (814) 454-3174

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1396692422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-864-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064508",
            "telephone_number": "814-454-3174",
            "fax_number": "814-616-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK COMMUNITY HOSPITAL",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "NEJMAN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "814-868-2507"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LECOM Institute for Behavioral Health-West Grandview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.