Organization Name: | PSYCH CONSULTANTS OF LEHIGH VALLEY |
NPI Number: | 1144605643 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOAN CICCHIELLO (EXECUTIVE DIRECTOR) |
Mailing Address: | 601 W 5th St Mount Carmel |
State: | PA US |
Postal Code: | 178511803 |
Phone Number: | 5708758058 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2015 |
NPI Last Update Date: | 08/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |