NPIMap

Organization Active NPI

Community Guidance Center

  • Community/Behavioral Health Agency
  • Indiana, PA
National Provider Identifier
1609862622
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
421220 Issued in PA
Legal business name
COMMUNITY GUIDANCE CENTER
Practice address
793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone
(724) 465-5576
Fax
(724) 463-3262
NPI assigned
Sep 26, 2005
Last updated
Oct 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Darrin J Mikula
Title
Cfo
Phone
(724) 465-5576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 421220 PA Primary

Addresses

Primary practice location

793 Old Route 119 Hwy N
Indiana, PA 15701-1372

Mailing address

793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone (724) 465-5576

Other identifiers 1

IdentifierTypeStateIssuer
100003328MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000420 PA Part B Supplier - Clinic/Group Practice 7517850720 Receives reassigned benefits from 20 practitioners
Practice locations: Punxsutawney, PA; Indiana, PA; Clearfield, PA; Clarksburg, PA; Du Bois, PA

National Provider Directory

National Provider Directory

Locations

600 Leonard St
Clearfield, PA 16830
Phone (814) 420-8673

1222 S Brady St
Du Bois, PA 15801
Phone (814) 503-8637

4893 State Route 30
Greensburg, PA 15601

4205 Crawford Ave
Northern Cambria, PA 15714
Phone (814) 420-8673

200 Prushnok Dr
Ste 103
Punxsutawney, PA 15767
Phone (814) 938-4444

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1609862622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 OLD ROUTE 119 HWY N",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011372",
            "telephone_number": "724-465-5576",
            "fax_number": "724-463-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 OLD ROUTE 119 HWY N",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011372",
            "telephone_number": "724-465-5576",
            "fax_number": "724-463-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY GUIDANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "MIKULA",
        "authorized_official_first_name": "DARRIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "724-465-5576"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "421220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003328",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.