NPIMap

Organization Active NPI

Luzerne Wyoming County MH Center #1

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tunkhannock, PA
National Provider Identifier
1710007166
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
22490 Issued in PA
Legal business name
LUZERNE WYOMING COUNTY MH CENTER #1
Practice address
99 Bridge St
Tunkhannock, PA 18657-1303
Phone
(570) 836-3118
Fax
(570) 836-1117
NPI assigned
Mar 30, 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
Joseph H Knecht
Title
Ceo
Phone
(570) 552-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 22490 PA Primary

Addresses

Primary practice location

99 Bridge St
Tunkhannock, PA 18657-1303

Mailing address

562 Wyoming Ave
Kingston, PA 18704-3721
Phone (570) 552-3900

Other identifiers 1

IdentifierTypeStateIssuer
100002080-0027MedicaidPA

Other names 1

  • Community Counseling Services of NEPA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comm Couns Serv N E PA36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

562 Wyoming Ave
Wilkes Barre, PA 18704
Phone (570) 552-3700

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710007166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043721",
            "telephone_number": "570-552-3900",
            "fax_number": "570-552-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BRIDGE ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571303",
            "telephone_number": "570-836-3118",
            "fax_number": "570-836-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZERNE WYOMING COUNTY MH CENTER #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNECHT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-552-3900"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "22490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002080-0027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Counseling Services of NEPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tunkhannock, 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.