Wyoming Valley Childrens Association
Organization Active NPI Behavior Analyst · Forty Fort, PA
NPI 1639213473 · NPPES record last updated Sep 25, 2025
Key facts
- NPI
- 1639213473
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Analyst 103K00000X
- Legal business name
- WYOMING VALLEY CHILDRENS ASSOCIATION
- Practice address
- 1133 Wyoming Ave
Forty Fort, PA 18704-4003 - Phone
- (570) 714-1246
- Fax
- (570) 714-1249
- NPI assigned
- Feb 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Nina Zanon
- Title
- Office Manager
- Phone
- (570) 714-1246
Practitioners 15
-
Shari R Aude, OTRL
-
Megan Elizabeth Florio, M.S., CCC-SLP
-
Erin Nicole Holby, M.S., CCC-SLP
-
Elisabeth Kapolka, SLP
-
Mary Sooy, PSY.D.
-
Jane Zak, OTR/L
-
Irene U Ziegler, LPT
-
Jessica Marie Zielecki, PT, DPT
-
Michael E Kelley, PHD
-
Caitlin Baloga, CCC-SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250401000507 | PA | Part B Supplier - Clinic/Group Practice | 6305369323 |
Receives reassigned benefits from 11 practitioners Practice locations: Forty Fort, PA |
National Provider Directory
Locations
1133 Wyoming Ave
Kingston, PA 18704
Phone (570) 714-1246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | Yes | ||
| Clinical Psychologist |
103TC0700X | |||
| Clinical Child & Adolescent Psychologist |
103TC2200X | |||
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Local Education Agency (LEA) | 251300000X |
Addresses
Primary practice location
1133 Wyoming Ave
Forty Fort, PA 18704-4003
Mailing address
1133 Wyoming Ave
Forty Fort, PA 18704-4003
Phone (570) 714-1246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000034800004 | Medicaid | PA |
Other providers in Forty Fort, PA
- Wilkes Barre Home Care Services LLC
- William H Boyle, MD PC
- Erin Williams
- Emily Witts
- Aimee-Lee Wright
- Wyoming Valley Chiropractic Inc
- Wyoming Valley Family Chiropractic Center
- Wyoming Valley Pet Associates
- Alexandra Yanez
- Maya Yoder
All providers in Forty Fort, PA · Behavior Analyst in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.