Organization
DIAKON LUTHERAN SOCIAL MINISTRIES
Active
Organization
DIAKON LUTHERAN SOCIAL MINISTRIES
Active
Other names
Diakon Family Life Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RITA ROUSSEAU (EXECUTIVE DIRECTOR COS)
(717) 795-0368
Entity
Organization
Contact information
Practice address
435 W 4TH ST, WILLIAMSPORT, PA 17701-6001
(570) 322-7873
(570) 322-8026
Mailing address
435 W 4TH ST, WILLIAMSPORT, PA 17701-6001
(570) 322-7873
(570) 322-8026
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02319100
CAPITAL BLUE CROSS
PA
01
—
080465
FPH - PSYCHOLOGIST
PA
05
—
1007777400006
—
PA
05
—
1007777400036
—
PA
01
—
1443618
PA BLUE SHIELD - PSYCHOLO
PA
01
—
1526223
PA BLUE SHIELD - CRNP
PA
01
—
1808012
PA BS - LCSW FEP ONLY
PA
01
—
301029
VALUEOPTIONS
PA
01
—
716009
PA BLUE SHIELD - MD/DO
PA
01
—
803181
FIRST PRIORITY HEALTH
PW
Enumeration date
06/16/2006
Last updated
11/11/2010
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