| Aviva Mental Health Services Inc | |
|
320 Macdade Blvd Suite #205 Collingdale PA 19023 | |
| (610) 522-4506 | |
| (610) 522-4507 |
| Full Name | Aviva Mental Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 Macdade Blvd, Collingdale, Pennsylvania |
| Authorized Official Name and Position | Susmaria Charles (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6105224506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aviva Mental Health Services Inc 320 Macdade Blvd Ste 205 Collingdale PA 19023-1926 Ph: (610) 522-4506 | Aviva Mental Health Services Inc 320 Macdade Blvd Suite #205 Collingdale PA 19023 Ph: (610) 522-4506 |
| NPI Number | 1083110605 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 05/28/2019 |
| Medicare PECOS PAC ID | 6709119944 |
|---|---|
| Medicare Enrollment ID | O20190604000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083110605 | NPI | - | NPPES |
| 143750 | Medicaid | PA | |
| 144120 | Medicaid | PA |
| Provider Name | Lucille E Venturanza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033269881 PECOS PAC ID: 3678634045 Enrollment ID: I20081203000548 |
| Provider Name | Jenika L Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255503892 PECOS PAC ID: 7113249855 Enrollment ID: I20141208000595 |
| Provider Name | James J Nestor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801055611 PECOS PAC ID: 1658615679 Enrollment ID: I20181203001321 |
| Provider Name | Marc A Exilus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588149587 PECOS PAC ID: 9830431915 Enrollment ID: I20190422002402 |
| Provider Name | Elmer Yu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841226545 PECOS PAC ID: 6305060393 Enrollment ID: I20190822000012 |
Aviva Mental Health Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Macdade Blvd Ste 205, Collingdale, PA 19023 Phone: 610-522-4506 Fax: 610-522-4508 | |
Aviva Mental Health Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17 S Macdade Blvd # 105, Collingdale, PA 19023 Phone: 610-522-4506 Fax: 610-522-4508 |