NPIMap

Organization Active NPI

Clearfield-Jefferson CMHC

  • Community/Behavioral Health Agency
  • Du Bois, PA
National Provider Identifier
1548381981
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
413980 Issued in PA
Legal business name
CLEARFIELD-JEFFERSON CMHC
Practice address
100 Caldwell Dr
Du Bois, PA 15801-1152
Phone
(814) 371-1100
Fax
(814) 371-3671
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen H Forsha, B. S. EDUCATION
Title
Billing Suprvisor
Phone
(814) 371-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 413980 PA Primary

Addresses

Primary practice location

100 Caldwell Dr
Du Bois, PA 15801-1152

Mailing address

100 Caldwell Dr
Du Bois, PA 15801-1152
Phone (814) 371-1100

Other identifiers 1

IdentifierTypeStateIssuer
1007627390030MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Clearfield-Jefferson CMHC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548381981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CALDWELL DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011152",
            "telephone_number": "814-371-1100",
            "fax_number": "814-371-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CALDWELL DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011152",
            "telephone_number": "814-371-1100",
            "fax_number": "814-371-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARFIELD-JEFFERSON CMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORSHA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BILLING SUPRVISOR",
        "authorized_official_telephone_number": "814-371-1100",
        "authorized_official_credential": "B. S. EDUCATION"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "413980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007627390030",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.