1881620250 NPI number — BERKS COUNSELING CENTER, INC.

Table of content: (NPI 1881620250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881620250 NPI number — BERKS COUNSELING CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERKS COUNSELING CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881620250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
645 PENN STREET
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-373-4281
Provider Business Mailing Address Fax Number:
610-373-3779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
645 PENN STREET
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-373-4281
Provider Business Practice Location Address Fax Number:
610-373-3779
Provider Enumeration Date:
06/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AXFORD
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
MARY
Authorized Official Title or Position:
DEPUTY DIRECTOR
Authorized Official Telephone Number:
610-373-4281

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  067063 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 206900 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 223690 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 543489000 . This is a "MAGELLAN PROVIDER I.D." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001898953 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001937640 . This is a "MA PROVIDER I.D." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001042570 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 093397000 . This is a "MAGELLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100737431 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2022751 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1547737 . This is a "GATEWAY CBHNP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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