# PINE RUN MENTAL HEALTH & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902624869
- **Authorized official:** DAVID CHRISTOPHER PETERSEN NP (PMHNP/OWNER)
- **Authorized official phone:** (570) 215-9965

## Contact information

- **Practice address:** 400 MARKET ST, WILLIAMSPORT, PA 17701-6344
- **Practice address phone:** (929) 724-2277
- **Practice address fax:** (929) 724-2277
- **Mailing address:** 2319 PINE RUN RD, LINDEN, PA 17744-8149
- **Mailing address phone:** (570) 215-9965
- **Mailing address fax:** (570) 215-9965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2024
- **Last updated:** 07/06/2026