| Corry Counseling Services Center Inc | |
|
45 E Washington St Corry PA 16407-1638 | |
| (814) 664-7761 | |
| (814) 664-4020 |
| Full Name | Corry Counseling Services Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 45 E Washington St, Corry, Pennsylvania |
| Authorized Official Name and Position | Janet Wittmann (CFO) |
| Authorized Official Contact | 8147201058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corry Counseling Services Center Inc 45 E Washington St Corry PA 16407-1638 Ph: (814) 664-7761 | Corry Counseling Services Center Inc 45 E Washington St Corry PA 16407-1638 Ph: (814) 664-7761 |
| NPI Number | 1417968439 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 07/27/2023 |
| Certification Date | 07/27/2023 |
| Medicare PECOS PAC ID | 7214975283 |
|---|---|
| Medicare Enrollment ID | O20050420000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417968439 | NPI | - | NPPES |
| 1000025270009 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 452010 (Pennsylvania) | Primary |
| Provider Name | Asha Prabhu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376634550 PECOS PAC ID: 2365481215 Enrollment ID: I20050429000129 |
| Provider Name | Kelly C Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033549605 PECOS PAC ID: 5890924443 Enrollment ID: I20140131001459 |
| Provider Name | Brenton Jay Seung Hoon Song |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184117004 PECOS PAC ID: 7012374630 Enrollment ID: I20230613000740 |
| Provider Name | Amy Durie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205252525 PECOS PAC ID: 7214384270 Enrollment ID: I20231113002254 |
| Provider Name | Jaymes Vroman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871220319 PECOS PAC ID: 6709225899 Enrollment ID: I20240423001312 |
| Provider Name | Matthew Copley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861950610 PECOS PAC ID: 5496196206 Enrollment ID: I20240510001824 |
Counselling Services Center Of Southeastern Erie County, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 E Washington St, Corry, PA 16407 Phone: 814-664-7761 Fax: 814-664-4020 | |
Behavioral Health Unit Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 W Smith St, Corry, PA 16407 Phone: 814-664-4641 Fax: 814-664-8799 | |
Counselling Services Center Of Southeastern Erie County, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 E Washington St, Corry, PA 16407 Phone: 814-664-7761 Fax: 814-664-4020 | |
Empowering Counseling Services, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 N Center St, Corry, PA 16407 Phone: 814-462-7869 Fax: 814-664-2552 | |
Gecac D&a Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 E Washington St, Corry, PA 16407 Phone: 814-664-8838 Fax: 814-664-4020 |