Providence Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SW132221 Issued in PA

Legal business name

PROVIDENCE COMMUNITY SERVICES

Practice address

41 Crystal St
Apt 4
East Stroudsburg, PA 18301-2874

Phone

(570) 350-1294

NPI assigned

Jun 2, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Shahida L Jones, LSW

Title

Therapist

Phone

(570) 350-1294

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1871973073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CRYSTAL ST",
            "address_2": "APT 4",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012874",
            "telephone_number": "570-350-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CRYSTAL ST",
            "address_2": "APT 4",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012874",
            "telephone_number": "570-350-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SHAHIDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "570-350-1294",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "SW132221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.