| Community Counseling Center Of Mercer County | |
|
107 Breckenridge St Ste 1 Grove City PA 16127-1025 | |
| (724) 458-4144 | |
| (724) 458-4157 |
| Full Name | Community Counseling Center Of Mercer County |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 Breckenridge St Ste 1, Grove City, Pennsylvania |
| Authorized Official Name and Position | Fern Maureen Torok (COMMUNITY OUTREACH AND DEVELOPMENT) |
| Authorized Official Contact | 7249817141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Counseling Center Of Mercer County 2201 E State St Hermitage PA 16148-2727 Ph: (724) 981-7141 | Community Counseling Center Of Mercer County 107 Breckenridge St Ste 1 Grove City PA 16127-1025 Ph: (724) 458-4144 |
| NPI Number | 1972727048 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 03/03/2010 |
| Medicare PECOS PAC ID | 7810981503 |
|---|---|
| Medicare Enrollment ID | O20040414000823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972727048 | NPI | - | NPPES |
| 100000380 0038 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 402750 (Pennsylvania) | Primary |
| Provider Name | Terrie J Bales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801851423 PECOS PAC ID: 7416990890 Enrollment ID: I20050607000336 |
| Provider Name | Jose Santiago |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487718391 PECOS PAC ID: 2860425394 Enrollment ID: I20050915000397 |
| Provider Name | Kimberly K Mathos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003911512 PECOS PAC ID: 6709964786 Enrollment ID: I20080416000059 |
| Provider Name | Krista M Laux |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427499144 PECOS PAC ID: 3072816875 Enrollment ID: I20160128002004 |
| Provider Name | Rodney W Carson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770856775 PECOS PAC ID: 4688922479 Enrollment ID: I20180810001245 |
| Provider Name | Jillian K Winklevoss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790276129 PECOS PAC ID: 8123405347 Enrollment ID: I20220510000027 |
| Provider Name | Krista Armstrong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760994115 PECOS PAC ID: 7315399607 Enrollment ID: I20240306002621 |
| Provider Name | Scott A Clary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063796902 PECOS PAC ID: 4284070335 Enrollment ID: I20240311003941 |
| Provider Name | Danielle Reges |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790354991 PECOS PAC ID: 2769920354 Enrollment ID: I20240814001369 |
| Provider Name | Leigh A Sturm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073646360 PECOS PAC ID: 6305360165 Enrollment ID: I20250414002070 |
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