NPIMap

Organization Active NPI

Lycoming Therapeutic Wrap Around Services, Inc

  • Clinical Psychologist
  • Williamsport, PA
National Provider Identifier
1831245570
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS008553L Issued in PA
Legal business name
LYCOMING THERAPEUTIC WRAP AROUND SERVICES, INC
Practice address
1521 Washington Blvd
Williamsport, PA 17701-5426
Phone
(570) 322-5051
Fax
(570) 322-6788
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. John S Neil, DR
Title
Owner
Phone
(570) 322-5051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS008553L PA Primary

Addresses

Primary practice location

1521 Washington Blvd
Williamsport, PA 17701-5426

Mailing address

1521 Washington Blvd
Williamsport, PA 17701-5426
Phone (570) 322-5051

Other practice location 1

1500 Sycamore Rd
Suite 330
Montoursville, PA 17754-9303
Phone (570) 322-2155

Other identifiers 1

IdentifierTypeStateIssuer
1011074990002MedicaidPA

National Provider Directory

National Provider Directory

Locations

1500 Sycamore Rd
Ste 330
Montoursville, PA 17754
Phone (570) 322-2155

1521 Washington Blvd
Williamsport, PA 17701
Phone (570) 322-5051

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831245570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 WASHINGTON BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015426",
            "telephone_number": "570-322-5051",
            "fax_number": "570-322-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 WASHINGTON BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015426",
            "telephone_number": "570-322-5051",
            "fax_number": "570-322-6788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Sycamore Rd",
            "address_2": "Suite 330",
            "address_purpose": "LOCATION",
            "city": "Montoursville",
            "state": "PA",
            "postal_code": "177549303",
            "country_code": "US",
            "telephone_number": "570-322-2155",
            "fax_number": "570-322-6788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LYCOMING THERAPEUTIC WRAP AROUND SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEIL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-322-5051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS008553L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011074990002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.