| Integrated Behavioral Healthcare Management Services, Inc. | |
|
900 Bryan St Suite 5 Huntingdon PA 16652-2413 | |
| (814) 643-6300 | |
| (814) 643-8776 |
| Full Name | Integrated Behavioral Healthcare Management Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 900 Bryan St, Huntingdon, Pennsylvania |
| Authorized Official Name and Position | Mark M. Peters (PRESIDENT/CEO) |
| Authorized Official Contact | 8146436300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Behavioral Healthcare Management Services, Inc. 900 Bryan Street Suite 5 Huntingdon PA 16652 Ph: (814) 643-6300 | Integrated Behavioral Healthcare Management Services, Inc. 900 Bryan St Suite 5 Huntingdon PA 16652-2413 Ph: (814) 643-6300 |
| NPI Number | 1598874414 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 03/11/2021 |
| Certification Date | 03/11/2021 |
| Medicare PECOS PAC ID | 3173500931 |
|---|---|
| Medicare Enrollment ID | O20040630000804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598874414 | NPI | - | NPPES |
| 1359155 | Other | PA | BLUE SHIELD |
| 100746486 | Medicaid | PA | |
| 1350119 | Other | PA | BLUE SHIELD (MANAGED CARE |
| Provider Name | Mukundam Veerabathini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306981964 PECOS PAC ID: 0941215685 Enrollment ID: I20060216000148 |
| Provider Name | Mary L Mccubbin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861531972 PECOS PAC ID: 8022116094 Enrollment ID: I20070614000565 |
| Provider Name | Margaret K Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770874125 PECOS PAC ID: 8527203710 Enrollment ID: I20130315000387 |
| Provider Name | Ebere A Anokwuru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619255825 PECOS PAC ID: 7315189123 Enrollment ID: I20130807000589 |
| Provider Name | George Walter Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164028817 PECOS PAC ID: 4587041496 Enrollment ID: I20220516001030 |
| Provider Name | Jonathan Angelo Aromatorio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598194011 PECOS PAC ID: 9032569215 Enrollment ID: I20240327001195 |
| Provider Name | Dorothy Bomgardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821484585 PECOS PAC ID: 6305296435 Enrollment ID: I20240416003722 |
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