| Advanced Community Service Associates | |
|
1141 Clay Ave Dunmore PA 18510-1191 | |
| (570) 207-7919 | |
| (570) 963-1953 |
| Full Name | Advanced Community Service Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 1141 Clay Ave, Dunmore, Pennsylvania |
| Authorized Official Name and Position | John E Bakes (DEPUTY DIRECTOR) |
| Authorized Official Contact | 5703486100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Community Service Associates 1141 Clay Ave Dunmore PA 18510-1191 Ph: () - | Advanced Community Service Associates 1141 Clay Ave Dunmore PA 18510-1191 Ph: (570) 207-7919 |
| NPI Number | 1851442586 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 01/11/2008 |
| Medicare PECOS PAC ID | 3971497157 |
|---|---|
| Medicare Enrollment ID | O20040210000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851442586 | NPI | - | NPPES |
| 1007706410012 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Sanjay S Chandragiri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467433060 PECOS PAC ID: 8224934047 Enrollment ID: I20031211000191 |
| Provider Name | Nelson K Asante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770546525 PECOS PAC ID: 9638198658 Enrollment ID: I20051118000039 |
| Provider Name | Rosemary D. Caolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154399962 PECOS PAC ID: 6800802018 Enrollment ID: I20060224000682 |
| Provider Name | Muhammed A Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417934498 PECOS PAC ID: 9537335658 Enrollment ID: I20111220000486 |
| Provider Name | Denise Marie Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043462948 PECOS PAC ID: 7113258161 Enrollment ID: I20191007001099 |
| Provider Name | Jacob Anthony Parrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730747858 PECOS PAC ID: 9335477470 Enrollment ID: I20220217000881 |
| Provider Name | Saroj Shrestha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598211971 PECOS PAC ID: 0244625507 Enrollment ID: I20220323001480 |
| Provider Name | Kristina Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639619513 PECOS PAC ID: 6800282211 Enrollment ID: I20220412002968 |
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