Organization
CARBON LEHIGH INTERMEDIATE #21
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SCOTT PSY D (DIRECTOR)
(610) 769-4111
Entity
Organization
Contact information
Practice address
770 STATE RD, LEHIGHTON, PA 18235-2857
(610) 769-4111
(610) 769-1168
Mailing address
4210 INDEPENDENCE DRIVE, SCHNECKSVILLE, PA 18078-2580
(610) 769-4111
(610) 769-1250
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100773170-0020
—
PA
Enumeration date
04/12/2007
Last updated
02/27/2023
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