Organization
NORTHERN TIER COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DENALULT (CEO)
(570) 265-0100
Entity
Organization
Contact information
Practice address
8 S MAIN ST, MANSFIELD, PA 16933-1530
(570) 265-0100
(570) 265-6741
Mailing address
24727 ROUTE 6, SUITE 2, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 265-6741
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
201550
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
201550
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
201550
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007540580042
—
PA
01
—
753722
HIGHMARK BLUE SHIELD
PA
01
—
801927
FPH-SOCIAL WORKER
—
01
—
801928
FIRST PRIORITY HEALTH-PSYCHIATRY
PA
01
—
CJ9872
RAILROAD MEDICARE
PA
Enumeration date
02/14/2014
Last updated
02/14/2014
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