NPIMap

Organization Active NPI

Tioga County Dept of Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mansfield, PA
National Provider Identifier
1689799181
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
597022 Issued in PA
Legal business name
TIOGA COUNTY DEPT OF HUMAN SERVICES
Practice address
St. James Complex
St. James and Third St. BLDG a Suite 109
Mansfield, PA 16933
Phone
(570) 662-7600
Fax
(570) 662-7726
NPI assigned
Mar 21, 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
Mr. Samuel Greene
Title
Administrator
Phone
(570) 724-5766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 597022 PA Primary

Addresses

Primary practice location

St. James Complex
St. James and Third St. BLDG a Suite 109
Mansfield, PA 16933

Mailing address

1873 Shumway Hill Rd
Wellsboro, PA 16901-6840
Phone (570) 724-5766

Other identifiers 1

IdentifierTypeStateIssuer
1000000400007MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Tioga County Dept of Human Services16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689799181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 SHUMWAY HILL RD",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169016840",
            "telephone_number": "570-724-5766",
            "fax_number": "570-724-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. JAMES COMPLEX",
            "address_2": "ST. JAMES AND THIRD ST. BLDG A SUITE 109",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16933",
            "telephone_number": "570-662-7600",
            "fax_number": "570-662-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIOGA COUNTY DEPT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-724-5766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "597022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000000400007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, 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.