| The Florence Child Guidance Center, Pinebrook Family Services | |
|
402 N Fulton St Allentown PA 18102-2002 | |
| (610) 432-3919 | |
| (610) 432-5174 |
| Full Name | The Florence Child Guidance Center, Pinebrook Family Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 N Fulton St, Allentown, Pennsylvania |
| Authorized Official Name and Position | Leslie Tenbroeck (VICE PRESIDENT) |
| Authorized Official Contact | 6107741434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Florence Child Guidance Center, Pinebrook Family Services 402 N Fulton St Allentown PA 18102-2002 Ph: (610) 432-3919 | The Florence Child Guidance Center, Pinebrook Family Services 402 N Fulton St Allentown PA 18102-2002 Ph: (610) 432-3919 |
| NPI Number | 1568647642 |
|---|---|
| Provider Enumeration Date | 01/08/2008 |
| Last Update Date | 11/17/2020 |
| Certification Date | 11/17/2020 |
| Medicare PECOS PAC ID | 6103149059 |
|---|---|
| Medicare Enrollment ID | O20141229000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568647642 | NPI | - | NPPES |
| 100759368 0012 | Medicaid | PA | |
| 100759368 0009 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Anil Saxena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124001086 PECOS PAC ID: 1850204033 Enrollment ID: I20031112000663 |
| Provider Name | Richard Solga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477643450 PECOS PAC ID: 2062311806 Enrollment ID: I20031231000334 |
| Provider Name | Nouzha Tazi Mzaalek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972712990 PECOS PAC ID: 6901959758 Enrollment ID: I20090728000096 |
| Provider Name | Anne Elizabeth Hills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336166107 PECOS PAC ID: 8325289978 Enrollment ID: I20130725000019 |
| Provider Name | Ekaete Oyeka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366093692 PECOS PAC ID: 7618304247 Enrollment ID: I20231107000080 |
| Provider Name | Leslie Ann Tenbroeck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982817185 PECOS PAC ID: 5496104119 Enrollment ID: I20231206004136 |
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