Organization
CSIU 16
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL FAULKNER PH.D. (DIRECTOR OF OUTPATIENT PSYCHOLOGICA)
(252) 432-1304
Entity
Organization
Contact information
Practice address
90 LAWTON LN, MILTON, PA 17847-9756
(570) 523-1155
Mailing address
90 LAWTON LN, MILTON, PA 17847-9756
(570) 523-1155
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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