Fulton Behavioral Health Services PC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

FULTON BEHAVIORAL HEALTH SERVICES PC

Practice address

214 Peach Orchard Road
MC Connellsburg, PA 17233

Phone

(717) 485-6120

Fax

(717) 485-6106

NPI assigned

Sep 23, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth T. Gotwals, MSW,LCSW,ACSW,QCSWNPI 1619951183

Title

Owner/Administrator

Phone

(717) 485-6120

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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

• Elizabeth T. Gotwals, MSW,LCSW,ACSW,QCSW

  • Social Worker
  • MC Connellsburg, PA
  • NPI 1619951183
  Medicare reassignment NPD Authorized official
• Stephanie E. Rakoczy-Schetrompf, LCSW

  • Social Worker
  • Everett, PA
  • NPI 1205166329
  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1962736934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 PEACH ORCHARD ROAD",
            "city": "MC CONNELLSBURG",
            "state": "PA",
            "postal_code": "17233",
            "telephone_number": "717-485-6120",
            "fax_number": "717-485-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PEACH ORCHARD ROAD",
            "city": "MC CONNELLSBURG",
            "state": "PA",
            "postal_code": "17233",
            "telephone_number": "717-485-6120",
            "fax_number": "717-485-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON BEHAVIORAL HEALTH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "GOTWALS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "717-485-6120",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW,LCSW,ACSW,QCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018117730001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024376860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andy John Fleck, PT
• Foot and Ankle Specialists of the Mid-Atlantic, LLC
• Gregory Franko, PA-C
• Aubrey Fry, PHARMD
• Fulton Alternative Services, LLC
• Fulton County Chiropractic LLC
• Fulton County Medical Center
• Fulton County Medical Center
• Fulton County Medical Center
• Fulton County Medical Center

• Social Worker in MC Connellsburg, PA
• Providers in MC Connellsburg, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.