Provider Demographics
NPI:1033257290
Name:PARAKLESEOS
Entity Type:Organization
Organization Name:PARAKLESEOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:FLANNICK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:724-775-7755
Mailing Address - Street 1:347 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2356
Mailing Address - Country:US
Mailing Address - Phone:724-775-7755
Mailing Address - Fax:724-775-3124
Practice Address - Street 1:347 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2356
Practice Address - Country:US
Practice Address - Phone:724-775-7755
Practice Address - Fax:724-775-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004317L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTRICARE
PA4645982Medicare UPIN
PA1756719Medicare UPIN
PA324170Medicare UPIN