| Diakon Child, Family & Community Ministries | |
|
435 W 4th St Williamsport PA 17701-6001 | |
| (570) 322-7873 | |
| (570) 322-8026 |
| Full Name | Diakon Child, Family & Community Ministries |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 435 W 4th St, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Deborah P White (DIR OF ADM OPS) |
| Authorized Official Contact | 5703227878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diakon Child, Family & Community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: () - | Diakon Child, Family & Community Ministries 435 W 4th St Williamsport PA 17701-6001 Ph: (570) 322-7873 |
| NPI Number | 1861802035 |
|---|---|
| Provider Enumeration Date | 04/28/2014 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Medicare PECOS PAC ID | 8820310279 |
|---|---|
| Medicare Enrollment ID | O20141215000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861802035 | NPI | - | NPPES |
| 1029202560001 | Medicaid | PA | |
| 102920256 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 331610 (Pennsylvania) | Primary |
| Provider Name | Douglas R Reed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801830443 PECOS PAC ID: 2365414943 Enrollment ID: I20040812001074 |
| Provider Name | Jagadeesh K Moola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952307746 PECOS PAC ID: 3274593868 Enrollment ID: I20041018000975 |
| Provider Name | Bernadette Itle Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770513160 PECOS PAC ID: 1951311752 Enrollment ID: I20060424000538 |
| Provider Name | Muhammad Ikram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477731180 PECOS PAC ID: 6103996566 Enrollment ID: I20080528000627 |
| Provider Name | Ilene Vangilder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679839765 PECOS PAC ID: 1951552587 Enrollment ID: I20121108000086 |
| Provider Name | Wanda Louise Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619131257 PECOS PAC ID: 8820221807 Enrollment ID: I20140428000851 |
| Provider Name | Faraz A Tyeb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639458417 PECOS PAC ID: 5395057640 Enrollment ID: I20150630000994 |
| Provider Name | Claudia J Dewane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245715143 PECOS PAC ID: 9537404884 Enrollment ID: I20181214002060 |
| Provider Name | Elkins Guzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679952451 PECOS PAC ID: 9830525575 Enrollment ID: I20200129000006 |
| Provider Name | Tracy Anne Ericson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063600302 PECOS PAC ID: 6406267996 Enrollment ID: I20201207000245 |
| Provider Name | Teresa Jean Crayton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194988485 PECOS PAC ID: 2163964610 Enrollment ID: I20240823001023 |
Gillum Psychological & Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Washington Boulevard, Suite 100, Williamsport, PA 17701 Phone: 570-321-6390 Fax: 570-321-6393 | |
Empowering Us Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 W 4th St, Williamsport, PA 17701 Phone: 570-360-9677 | |
Lawrence M Satifka Ma Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Pine St Ste 400, Williamsport, PA 17701 Phone: 570-772-3090 Fax: 570-300-2371 | |
Diakon Child, Family & Community Ministries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 435 W 4th St, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 | |
Williamsport Psychological Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 811 Market St, Williamsport, PA 17701 Phone: 570-322-2603 Fax: 570-322-4208 | |
Diakon Child,family&community Ministries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Loyalsock Dr, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 | |
Susquehanna Physician Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 740 High St, Suite 4001, Williamsport, PA 17701 Phone: 570-321-2345 Fax: 570-321-2359 |