| Susquehanna Valley Professional Associates, Inc | |
|
320 Rolling Ridge Dr Suite 100 State College PA 16801-7641 | |
| (814) 867-0670 | |
| (814) 867-7616 |
| Full Name | Susquehanna Valley Professional Associates, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 320 Rolling Ridge Dr, State College, Pennsylvania |
| Authorized Official Name and Position | Timothy Hans Derstine (MANAGING DIRECTOR) |
| Authorized Official Contact | 8148679755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susquehanna Valley Professional Associates, Inc 320 Rolling Ridge Dr Suite 100 State College PA 16801-7641 Ph: (814) 867-0670 | Susquehanna Valley Professional Associates, Inc 320 Rolling Ridge Dr Suite 100 State College PA 16801-7641 Ph: (814) 867-0670 |
| NPI Number | 1578543054 |
|---|---|
| Provider Enumeration Date | 01/19/2006 |
| Last Update Date | 04/15/2015 |
| Medicare PECOS PAC ID | 5395648745 |
|---|---|
| Medicare Enrollment ID | O20040202000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578543054 | NPI | - | NPPES |
| 02892000 | Other | PA | CAPITAL BLUE CROSS |
| Provider Name | Candace R Good |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144293770 PECOS PAC ID: 4880666445 Enrollment ID: I20040812000924 |
| Provider Name | Elaine Piccioni Higdon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811927684 PECOS PAC ID: 5597724757 Enrollment ID: I20041005000403 |
| Provider Name | Arthur John J Decarle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356349450 PECOS PAC ID: 2567429954 Enrollment ID: I20041217000015 |
| Provider Name | Carol L Glaskin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437201290 PECOS PAC ID: 8820015274 Enrollment ID: I20051026000084 |
| Provider Name | Brian Garrett Rockower |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225062508 PECOS PAC ID: 1052315314 Enrollment ID: I20060830000004 |
| Provider Name | Sandra Brill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821144361 PECOS PAC ID: 7315025434 Enrollment ID: I20080415000407 |
| Provider Name | Amy D Criscitello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134452055 PECOS PAC ID: 5597802553 Enrollment ID: I20091023000017 |
| Provider Name | Craig S Feaster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912905795 PECOS PAC ID: 4587780929 Enrollment ID: I20100923000265 |
| Provider Name | Michael Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194755512 PECOS PAC ID: 6901091834 Enrollment ID: I20101117000446 |
| Provider Name | Kathy Furr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235157256 PECOS PAC ID: 1355537218 Enrollment ID: I20101118000554 |
| Provider Name | Michael J Cawley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033134259 PECOS PAC ID: 9133381395 Enrollment ID: I20120504000025 |
| Provider Name | Lynette Turay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861507923 PECOS PAC ID: 2668642398 Enrollment ID: I20120530000299 |
| Provider Name | Dennis J Dombrowski |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1528261328 PECOS PAC ID: 4385809813 Enrollment ID: I20120706000195 |
| Provider Name | Melissa C Stokes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780897249 PECOS PAC ID: 9032303763 Enrollment ID: I20120727000350 |
| Provider Name | Michael Md Turk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720198815 PECOS PAC ID: 2567692908 Enrollment ID: I20140304000157 |
| Provider Name | Ruth E Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295138899 PECOS PAC ID: 5395068977 Enrollment ID: I20150107000698 |
| Provider Name | David S Helsel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669463840 PECOS PAC ID: 2961428404 Enrollment ID: I20151016000185 |
| Provider Name | Alexandra Ebken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386922177 PECOS PAC ID: 9537416623 Enrollment ID: I20180720000151 |
| Provider Name | John J Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043791866 PECOS PAC ID: 1355692633 Enrollment ID: I20180926000301 |
| Provider Name | Jami A Pavlak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265770010 PECOS PAC ID: 9830334945 Enrollment ID: I20220720003972 |
| Provider Name | Rose Mary Catchmark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275032559 PECOS PAC ID: 7618327297 Enrollment ID: I20240402000750 |
Gracanne Pearl Dreibelbis-drapcho Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Rolling Ridge Dr, Suite 100, State College, PA 16801 Phone: 814-860-0670 Fax: 814-867-7616 | |
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