Organization
AVIVA MENTAL HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSMARIA CHARLES MHS;CPSS (CLINICAL DIRECTOR)
(610) 522-4506
Entity
Organization
Contact information
Practice address
14-20 MACDADE BLVD STE A, COLLINGDALE, PA 19023-1822
(610) 522-4506
(610) 522-4508
Mailing address
14-20 MACDADE BLVD STE A, COLLINGDALE, PA 19023-1822
(610) 522-4506
(610) 522-4508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
143750
PA
101YM0800X
Mental Health Counselor
143750
PA
103T00000X
Psychologist
143750
PA
103TC2200X
Clinical Child & Adolescent Psychologist
143750
PA
106H00000X
Marriage & Family Therapist
143750
PA
163WP0808X
Psychiatric/Mental Health Registered Nurse
143750
PA
2084P0802X
Addiction Psychiatry Physician
143750
PA
2084P0804X
Child & Adolescent Psychiatry Physician
143650
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
143750
PA
261QM0850X
Adult Mental Health Clinic/Center
143750
PA
261QM0850X
Adult Mental Health Clinic/Center
144120
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
143750
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
143750
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143750
—
PA
05
—
144120
—
PA
Enumeration date
04/03/2018
Last updated
10/21/2025
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