Organization
FAMILY SERVICES OF NW PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN GRESH (CFO)
(814) 866-4504
Entity
Organization
Contact information
Practice address
5100 PEACH ST, ERIE, PA 16509-2482
(814) 866-4500
(814) 864-2677
Mailing address
5100 PEACH ST, ERIE, PA 16509-2482
(814) 866-4500
(814) 864-2677
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007436350006
—
PA
01
—
BLUE SHIELD
631888
PA
Enumeration date
05/12/2006
Last updated
01/24/2022
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