Organization
NORTHEASTERN BEHAVIORAL HEALTH, PC
Active
Organization
NORTHEASTERN BEHAVIORAL HEALTH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY KOWALIK LPC, CAADC (CHIEF EXECUTIVE OFFICER)
(570) 832-4339
Entity
Organization
Contact information
Practice address
140 BENNETT AVENUE, SUITE 1B, MILFORD, PA 18337
(570) 832-4339
Mailing address
140 BENNETT AVENUE, SUITE 1B, MILFORD, PA 18338
(570) 832-4339
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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