Organization
PSYCH CONSULTANTS BERK-LEHIGH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN M CICCHIELLO PMHNP (EXECUTIVE DIRECTOR)
(570) 875-9434
Entity
Organization
Contact information
Practice address
601 W 5TH ST, MOUNT CARMEL, PA 17851-1303
(570) 875-8058
(570) 554-4357
Mailing address
601 W 5TH ST, MOUNT CARMEL, PA 17851-1303
(570) 875-8058
(570) 554-4357
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
TP 006931C
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP009838
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
TP006931C
PA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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