NPIMap

Organization Active NPI

Arbor Vitae Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Lakeville, PA
National Provider Identifier
1790265692
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ARBOR VITAE BEHAVIORAL HEALTH, LLC
Practice address
1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone
(570) 647-9277
Fax
(570) 227-0084
NPI assigned
Aug 20, 2018
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Kelly Sheridan Lawrence, LPC, CRNP, PMHNP-BCNPI 1902066996
Title
Owner
Phone
(570) 647-9277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1258 Purdytown Tpke
Lakeville, PA 18438-6793

Mailing address

1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone (570) 647-9277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719001686 PA Part B Supplier - Clinic/Group Practice 9537529789 Receives reassigned benefits from 5 practitioners
Practice locations: Lakeville, PA

National Provider Directory

National Provider Directory

Locations

8 Silk Mill Dr
Ste 201
Hawley, PA 18428

1258 Purdytown Tpke
Lowr
Lakeville, PA 18438

Practitioners & affiliated clinicians

Practitioners 7

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": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1790265692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-647-9277",
            "fax_number": "570-227-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-647-9277",
            "fax_number": "570-227-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR VITAE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "SHERIDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-647-9277",
        "authorized_official_credential": "LPC, CRNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.