| Arbor Vitae Behavioral Health, Llc | |
|
1258 Purdytown Tpke Lakeville PA 18438-6793 | |
| (570) 647-9277 | |
| (570) 227-0084 |
| Full Name | Arbor Vitae Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1258 Purdytown Tpke, Lakeville, Pennsylvania |
| Authorized Official Name and Position | Kelly Sheridan Lawrence (OWNER) |
| Authorized Official Contact | 5706479277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arbor Vitae Behavioral Health, Llc 1258 Purdytown Tpke Lakeville PA 18438-6793 Ph: (570) 647-9277 | Arbor Vitae Behavioral Health, Llc 1258 Purdytown Tpke Lakeville PA 18438-6793 Ph: (570) 647-9277 |
| NPI Number | 1790265692 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Medicare PECOS PAC ID | 9537529789 |
|---|---|
| Medicare Enrollment ID | O20230719001686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790265692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Pennsylvania) | Primary |
| Provider Name | Kelly Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902066996 PECOS PAC ID: 0446610695 Enrollment ID: I20230719001941 |
Pcps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1258 Purdytown Tpke, Lakeville, PA 18438 Phone: 570-226-1963 Fax: 570-226-1967 | |
Suzanne L Grierson Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1258 Purdytown Tpke, Suite 2, Lakeville, PA 18438 Phone: 570-226-4444 Fax: 570-226-4333 | |
Linda S. Campbell, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1258 Purdytown Tpke Ste 101, Lakeville, PA 18438 Phone: 570-470-6190 Fax: 570-226-1967 | |
Jeanne H. Ross, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1258 Purdytown Tpke, Lakeville, PA 18438 Phone: 302-463-5434 | |
Sarah Van Belle, Phd, Lcsw, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1258 Purdytown Tpke, Lakeville, PA 18438 Phone: 570-369-4466 Fax: 877-356-1692 | |
Darlene Kay Nalesnik Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1258 Purdytown Tpke, Lakeville, PA 18438 Phone: 570-226-1963 Fax: 570-226-1967 |