NPIMap

Organization Active NPI

Diakon Child Family and Community Ministries

  • Community/Behavioral Health Agency
  • Williamsport, PA
National Provider Identifier
1548631583
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
331600 Issued in PA
Legal business name
DIAKON CHILD FAMILY AND COMMUNITY MINISTRIES
Practice address
2990 W 4TH St
Williamsport, PA 17701-4197
Phone
(570) 322-7873
NPI assigned
Oct 16, 2015
Last updated
Oct 16, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DIAKON LUTHERAN SOCIAL MINISTRIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Laurel SpencerNPI 1043386444
Title
Clinical Director
Phone
(570) 322-7873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 331600 PA Primary

Addresses

Primary practice location

2990 W 4TH St
Williamsport, PA 17701-4197

Mailing address

435 W 4TH St
Williamsport, PA 17701-6001

Other identifiers 2

IdentifierTypeStateIssuer
1029202560001MedicaidPA
379904OtherPAMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Diakon Child Family Community Ministries26 organizations share this tax ID, including this one
Part of
Diakon Lutheran Social Ministries

Other organizations with this tax ID 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1548631583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 W 4TH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177016001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 W 4TH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177014197",
            "telephone_number": "570-322-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAKON CHILD FAMILY AND COMMUNITY MINISTRIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIAKON LUTHERAN SOCIAL MINISTRIES",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "570-322-7873"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "331600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029202560001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "379904",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.