Provider Demographics
NPI:1417135021
Name:CATHOLIC SOCIAL SERVICES INC
Entity Type:Organization
Organization Name:CATHOLIC SOCIAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LSW
Authorized Official - Phone:570-829-3489
Mailing Address - Street 1:33 E NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-2406
Mailing Address - Country:US
Mailing Address - Phone:570-829-3489
Mailing Address - Fax:570-829-7781
Practice Address - Street 1:33 E NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-2406
Practice Address - Country:US
Practice Address - Phone:570-829-3489
Practice Address - Fax:570-829-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA401110251S00000X
PA667031251S00000X
PA667036251S00000X
PA527031251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100759297 0023Medicaid
PA100759297 0026Medicaid
PA100759297 0028Medicaid
PA100759297 0027Medicaid