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Organization
NORTHERN TIER COUNSELING, INC.
Active
Organization
NORTHERN TIER COUNSELING, INC.
Active
Other names
Northern Tier Counseling MH-Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DENAULT (CEO)
(570) 265-0100
Entity
Organization
Contact information
Practice address
24727 ROUTE 6 STE 2, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 265-6741
Mailing address
24727 ROUTE 6 STE 2, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 265-6741
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007540580040
—
PA
05
—
1007540580042
—
PA
05
—
1007540580073
—
PA
05
—
1007540580075
—
PA
01
—
753722
HIGHMARK BLUE SHIELD
PA
01
—
801928
FPH PROVIDER#-PSYCHIATRY
PA
Enumeration date
07/16/2006
Last updated
03/25/2015
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