Provider Demographics
NPI:1184650681
Name:JEWISH FAMILY SERVICE OF NORTHEASTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF NORTHEASTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ABDO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-344-1186
Mailing Address - Street 1:615 JEFFERSON AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1630
Mailing Address - Country:US
Mailing Address - Phone:570-344-1186
Mailing Address - Fax:570-344-7641
Practice Address - Street 1:615 JEFFERSON AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1630
Practice Address - Country:US
Practice Address - Phone:570-344-1186
Practice Address - Fax:570-344-7641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
JE767482Medicare ID - Type Unspecified