Provider Demographics
NPI:1205210903
Name:PSYCHOLOGICAL CONSULTANTS
Entity Type:Organization
Organization Name:PSYCHOLOGICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M PITINGOLO
Authorized Official - Last Name:CICCHIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:570-875-9434
Mailing Address - Street 1:1050 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3638
Mailing Address - Country:US
Mailing Address - Phone:570-875-8058
Mailing Address - Fax:570-554-4357
Practice Address - Street 1:603 W 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:PA
Practice Address - Zip Code:17851-1803
Practice Address - Country:US
Practice Address - Phone:570-875-8058
Practice Address - Fax:570-554-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WA0400X, 363LA2200X, 363LP0808X
PATP006931C163WG0000X
PASP009838163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty