| Diakon Child, Family & Community Ministries | |
|
435 W 4th St Williamsport PA 17701-6001 | |
| (570) 322-7873 | |
| (570) 322-8026 |
| Full Name | Diakon Child, Family & Community Ministries |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 435 W 4th St, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Deborah P White (DIR OF ADM OPS) |
| Authorized Official Contact | 5703227878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakon Child, Family & Community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: () - | Diakon Child, Family & Community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: (570) 322-7873 |
| NPI Number | 1861802035 |
|---|---|
| Provider Enumeration Date | 04/28/2014 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Medicare PECOS PAC ID | 8820310279 |
|---|---|
| Medicare Enrollment ID | O20141215000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861802035 | NPI | - | NPPES |
| 1029202560001 | Medicaid | PA | |
| 102920256 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 331610 (Pennsylvania) | Primary |
| Provider Name | Ronald L Pope |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578528865 PECOS PAC ID: 3476451923 Enrollment ID: I20031222000705 |
| Provider Name | William G Krieger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710105515 PECOS PAC ID: 0143121632 Enrollment ID: I20040116001066 |
| Provider Name | Forrest James Mclean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063474393 PECOS PAC ID: 8426029067 Enrollment ID: I20040805000541 |
| Provider Name | Douglas R Reed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801830443 PECOS PAC ID: 2365414943 Enrollment ID: I20040812001074 |
| Provider Name | Jagadeesh K Moola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952307746 PECOS PAC ID: 3274593868 Enrollment ID: I20041018000975 |
| Provider Name | Bernadette Itle Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770513160 PECOS PAC ID: 1951311752 Enrollment ID: I20060424000538 |
| Provider Name | Muhammad Ikram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477731180 PECOS PAC ID: 6103996566 Enrollment ID: I20080528000627 |
| Provider Name | Ilene Vangilder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679839765 PECOS PAC ID: 1951552587 Enrollment ID: I20121108000086 |
| Provider Name | Wanda Louise Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619131257 PECOS PAC ID: 8820221807 Enrollment ID: I20140428000851 |
| Provider Name | Faraz A Tyeb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639458417 PECOS PAC ID: 5395057640 Enrollment ID: I20150630000994 |
| Provider Name | Claudia J Dewane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245715143 PECOS PAC ID: 9537404884 Enrollment ID: I20181214002060 |
| Provider Name | Elkins Guzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679952451 PECOS PAC ID: 9830525575 Enrollment ID: I20200129000006 |
| Provider Name | Tracy Ericson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063600302 PECOS PAC ID: 6406267996 Enrollment ID: I20201207000245 |
Gillum Psychological & Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 454 Pine St, Suite 1b, Williamsport, PA 17701 Phone: 570-321-6390 Fax: 570-321-6393 | |
Crossroads Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 East Third Street, Williamsport, PA 17701 Phone: 570-323-7535 Fax: 570-323-3790 | |
Lawrence M Satifka Ma Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Pine St Ste 400, Williamsport, PA 17701 Phone: 570-772-3090 Fax: 570-300-2371 | |
L.c.c.c.s Children's Development Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 W Edwin St, Williamsport, PA 17701 Phone: 570-326-0565 Fax: 570-329-2522 | |
Diakon Family Life Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 435 W 4th St, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 | |
Williamsport Psychological Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 811 Market St, Williamsport, PA 17701 Phone: 570-322-2603 Fax: 570-322-4208 | |
Diakon Child,family&community Ministries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Loyalsock Dr, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 |