NPIMap

Organization Active NPI

Wyoming Valley Alchol and Drug Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Berwick, PA
National Provider Identifier
1831571413
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
197057 Issued in PA
Legal business name
WYOMING VALLEY ALCHOL AND DRUG SERVICES, INC.
Practice address
120 East Third Street
Berwick, PA 18603
Phone
(570) 820-8888
Fax
(570) 820-8899
NPI assigned
Jun 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Authorized official

Name
Jason Harlen, M.A.
Title
Ceo
Phone
(570) 820-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 197057 PA Primary

Addresses

Primary practice location

120 East Third Street
Berwick, PA 18603

Mailing address

437 North Main Street
Wilkes Barre, PA 18705
Phone (570) 820-8888

National Provider Directory

National Provider Directory
Tax ID family
Wyoming Valley Alcohol and Drug Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1831571413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 NORTH MAIN STREET",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18705",
            "telephone_number": "570-820-8888",
            "fax_number": "570-820-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EAST THIRD STREET",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "18603",
            "telephone_number": "570-820-8888",
            "fax_number": "570-820-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING VALLEY ALCHOL AND DRUG SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "HARLEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-820-8888",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "197057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwick, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.