NPIMap

Organization Active NPI

Childrens Center for Treatment and Education

Doing business as Beacon Light Behavioral Health Systems

  • Clinical Psychologist
  • Bradford, PA
National Provider Identifier
1477626992
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016644 Issued in PA
Legal business name
CHILDRENS CENTER FOR TREATMENT AND EDUCATION
Doing business as
Beacon Light Behavioral Health Systems
Practice address
800 E Main St
Bradford, PA 16701-3278
Phone
(814) 362-5248
Fax
(814) 362-5263
NPI assigned
Nov 15, 2006
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Mr. Richard Seager
Title
President/Ceo
Phone
(814) 368-3800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC004950 PA
Clinical Psychologist 103TC0700X PS016644 PA Primary
Social Worker 104100000X SW126127 PA
Clinical Social Worker 1041C0700X CW016316 PA

Addresses

Primary practice location

800 E Main St
Bradford, PA 16701-3278

Mailing address

800 E Main St
Bradford, PA 16701-3278
Phone (814) 362-5250

Other identifiers 3

IdentifierTypeStateIssuer
001989164OtherPAHIGHMARK - NON MANAGED CARE
1007710210049MedicaidPA
001989165OtherPAHIGHMARK- MANAGED CARE

Other names 1

  • 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
This NPI is an additional NPI on the 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
Tax ID family
Beacon Light Behavioral Health System14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

717 E Mill St
Port Allegany, PA 16743
Phone (814) 642-7236

623 Elm St
Tionesta, PA 16353
Phone (814) 723-1832

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1477626992",
    "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": "814-362-5250",
            "fax_number": "814-362-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167013278",
            "telephone_number": "814-362-5248",
            "fax_number": "814-362-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS CENTER FOR TREATMENT AND EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "SEAGER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "814-368-3800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004950",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016644",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW126127",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK - NON MANAGED CARE",
            "identifier": "001989164",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007710210049",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK- MANAGED CARE",
            "identifier": "001989165",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Light Behavioral Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.