Early Psychiatric & Counseling Service, P.C

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD053911-L Issued in PA

Legal business name

EARLY PSYCHIATRIC & COUNSELING SERVICE, P.C

Practice address

116 N 5TH St
W Hazleton, PA 18202-3946

Phone

(570) 454-2545

Fax

(570) 454-6191

NPI assigned

May 31, 2007

Last updated

May 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shafiq Ur Rahman, M.DNPI 1689759441

Title

President-Chief Psychiatrist

Phone

(570) 454-2545

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

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.

• Shafiq Ur Rahman, M.D

  • Psychiatry Physician
  • W Hazleton, PA
  • NPI 1689759441
  Medicare reassignment NPD Authorized official
• Henry F Smith Jr., MD

  • Specialist
  • Hazleton, PA
  • NPI 1225077571
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1831390343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187070100",
            "telephone_number": "570-454-2545",
            "fax_number": "570-454-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N 5TH ST",
            "city": "W HAZLETON",
            "state": "PA",
            "postal_code": "182023946",
            "telephone_number": "570-454-2545",
            "fax_number": "570-454-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY PSYCHIATRIC & COUNSELING SERVICE, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "SHAFIQ",
        "authorized_official_middle_name": "UR",
        "authorized_official_title_or_position": "PRESIDENT-CHIEF PSYCHIATRIST",
        "authorized_official_telephone_number": "570-454-2545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD053911-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015129990009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Joseph Brady Jr., D.D.S.,M.S.D.
• Christopher D. Justofin,D.O.,P.C.
• Derek Enterprises LLC (Pro Rehabilitiation Services)
• George E Kuzma, D.P.M.
• Neuropedic LLC (Neuropedic)
• Shafiq Ur Rahman, M.D
• Mark J Wende, DDS

• Psychiatry Physician in W Hazleton, PA
• Providers in W Hazleton, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.