NPIMap

Organization Active NPI

Northeast Counseling Services

  • Adolescent and Children Mental Health Clinic/Center
  • Hazleton, PA
National Provider Identifier
1396929121
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
1007615710034 Issued in PA
Legal business name
NORTHEAST COUNSELING SERVICES
Practice address
424 E 9TH St
Hazleton, PA 18201-3475
Phone
(570) 455-6385
NPI assigned
Dec 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Edmund Abdo Jr.
Title
Executive Director
Phone
(570) 735-7590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 1007615710034 PA Primary

Addresses

Primary practice location

424 E 9TH St
Hazleton, PA 18201-3475

Mailing address

750 E Broad St
Hazleton, PA 18201-6835
Phone (570) 455-6385

Other identifiers 1

IdentifierTypeStateIssuer
1007615710034MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Northeast Counseling Services53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1396929121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016835",
            "telephone_number": "570-455-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E 9TH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182013475",
            "telephone_number": "570-455-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "ABDO",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-735-7590",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "1007615710034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007615710034",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.