Organization
NORTHERN TIER COUNSELING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DENAULT (CEO)
(570) 265-0100
Entity
Organization
Contact information
Practice address
24727 ROUTE 6, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 268-2756
Mailing address
24727 ROUTE 6, SUITE 2, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 265-6741
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
221030
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000753722
HIGHMARK ID#-PSYCHIATRY
PA
05
—
1007540580103
—
PA
Enumeration date
03/16/2007
Last updated
12/16/2020
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