| Dickinson Center, Inc | |
|
43 Servidea Drive Ridgway PA 15853 | |
| (814) 776-2145 | |
| (814) 776-1470 |
| Full Name | Dickinson Center, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 43 Servidea Drive, Ridgway, Pennsylvania |
| Authorized Official Name and Position | John Goga (CEO) |
| Authorized Official Contact | 8147760250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dickinson Center, Inc 43 Servidea Drive Ridgway PA 15853 Ph: (814) 776-2145 | Dickinson Center, Inc 43 Servidea Drive Ridgway PA 15853 Ph: (814) 776-2145 |
| NPI Number | 1164503322 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 10/17/2012 |
| Medicare PECOS PAC ID | 3870489131 |
|---|---|
| Medicare Enrollment ID | O20040224000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164503322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 425090 (Pennsylvania) | Primary |
| Provider Name | Hridayesh Kumar Pathak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417989179 PECOS PAC ID: 6103893144 Enrollment ID: I20040910000517 |
| Provider Name | Craig G Richman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780664524 PECOS PAC ID: 1355374141 Enrollment ID: I20050913000448 |
| Provider Name | John R Michalowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457437212 PECOS PAC ID: 9638177546 Enrollment ID: I20061130000410 |
| Provider Name | Angela Nikol Chew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063723393 PECOS PAC ID: 1951597012 Enrollment ID: I20101201000627 |
| Provider Name | Melissa C Stokes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780897249 PECOS PAC ID: 9032303763 Enrollment ID: I20120727000350 |
| Provider Name | Amanda Carpin Straub |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366830150 PECOS PAC ID: 8729305107 Enrollment ID: I20150324000263 |
| Provider Name | Carol Bembenic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750626263 PECOS PAC ID: 6305154949 Enrollment ID: I20151001001865 |
| Provider Name | Justin Bauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508302670 PECOS PAC ID: 2062796352 Enrollment ID: I20170306001504 |
| Provider Name | Kristina Singley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558029017 PECOS PAC ID: 2062804222 Enrollment ID: I20220120000099 |
| Provider Name | Brandi Norris |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598454787 PECOS PAC ID: 5890146906 Enrollment ID: I20240112001118 |
| Provider Name | Jordan Philip Lefler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790327716 PECOS PAC ID: 2860844172 Enrollment ID: I20240122003896 |
| Provider Name | Alissa Rose Shelander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316559693 PECOS PAC ID: 6901343961 Enrollment ID: I20240808000233 |
| Provider Name | Stephanie Ann Hetrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588152938 PECOS PAC ID: 6709326838 Enrollment ID: I20240904002318 |
| Provider Name | Shelby Dietze |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912756842 PECOS PAC ID: 8123569118 Enrollment ID: I20240918000314 |
| Provider Name | Vikram Panwar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922493899 PECOS PAC ID: 9234436767 Enrollment ID: I20250131001430 |
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Nelson Behavioral Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Center St, Ridgway, PA 15853 Phone: 814-772-5546 Fax: 814-772-0511 |