| The Pennsylvania State University | |
|
501 Student Health Ctr University Park PA 16802-2129 | |
| (814) 863-0395 | |
| Not Available |
| Full Name | The Pennsylvania State University |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 501 Student Health Ctr, University Park, Pennsylvania |
| Authorized Official Name and Position | David Lindstrom (PRIVACY OFFICER) |
| Authorized Official Contact | 8148657211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Pennsylvania State University 501 Student Health Ctr University Park PA 16802-2129 Ph: (814) 863-0395 | The Pennsylvania State University 501 Student Health Ctr University Park PA 16802-2129 Ph: (814) 863-0395 |
| NPI Number | 1902152499 |
|---|---|
| Provider Enumeration Date | 08/02/2012 |
| Last Update Date | 08/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902152499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
The Pennsylvania State University Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 337 Moore Building, University Park, PA 16802 Phone: 814-865-2191 Fax: 814-863-1331 |