| Internet Behavioral Care, Pc | |
|
4610 E Street Rd Trevose PA 19053-6612 | |
| (800) 366-0129 | |
| (215) 638-1299 |
| Full Name | Internet Behavioral Care, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4610 E Street Rd, Trevose, Pennsylvania |
| Authorized Official Name and Position | Glenn Gabris (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6109413348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internet Behavioral Care, Pc 4610 E Street Rd Trevose PA 19053-6612 Ph: (800) 366-0129 | Internet Behavioral Care, Pc 4610 E Street Rd Trevose PA 19053-6612 Ph: (800) 366-0129 |
| NPI Number | 1962619841 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0244203891 |
|---|---|
| Medicare Enrollment ID | O20040813000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962619841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Peter Tor Swanljung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770620478 PECOS PAC ID: 8729184684 Enrollment ID: I20070509000554 |
| Provider Name | Allene Lyons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184822512 PECOS PAC ID: 4981754777 Enrollment ID: I20090617000357 |
| Provider Name | Alexander M Kanevsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780750299 PECOS PAC ID: 4587672803 Enrollment ID: I20091230000589 |
| Provider Name | Jacqueline Coyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093837817 PECOS PAC ID: 7719109867 Enrollment ID: I20141105002074 |
| Provider Name | Jeffrey H Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861651077 PECOS PAC ID: 5092037861 Enrollment ID: I20141205000211 |
| Provider Name | Diana P Keat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467542548 PECOS PAC ID: 0941526297 Enrollment ID: I20150303001679 |
| Provider Name | Jane Back |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265981963 PECOS PAC ID: 1658654371 Enrollment ID: I20170203000171 |
| Provider Name | Amy B Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780167940 PECOS PAC ID: 5294076659 Enrollment ID: I20190411001721 |
Garrison & Lees Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4432 E Bristol Rd, Trevose, PA 19053 Phone: 609-631-5193 Fax: 484-552-2755 | |
Ken-crest Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2820 Old Lincoln Hwy, Trevose, PA 19053 Phone: 610-825-9360 Fax: 610-825-4127 | |
Clarity Service Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Neshaminy Interplex, Suite 105, Trevose, PA 19053 Phone: 215-322-8860 Fax: 215-322-8867 |