Provider Demographics
NPI:1497485510
Name:942 PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:942 PSYCHIATRIC SERVICES
Other - Org Name:942 PSYCHIATRIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-767-9074
Mailing Address - Street 1:1290 BLAKESLEE BOULEVARD DR W STE 1
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-9352
Mailing Address - Country:US
Mailing Address - Phone:484-934-1155
Mailing Address - Fax:484-727-9991
Practice Address - Street 1:1290 BLAKESLEE BOULEVARD DR W STE 1
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9352
Practice Address - Country:US
Practice Address - Phone:484-934-1155
Practice Address - Fax:484-727-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty