Provider Demographics
NPI:1528193760
Name:PSYCHIATRIC ASSOCIATES OF CENTRAL PENNSYLVANIA
Entity Type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES OF CENTRAL PENNSYLVANIA
Other - Org Name:PACP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:717-730-8555
Mailing Address - Street 1:20 ERFORD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1163
Mailing Address - Country:US
Mailing Address - Phone:717-730-8555
Mailing Address - Fax:717-730-4566
Practice Address - Street 1:20 ERFORD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1163
Practice Address - Country:US
Practice Address - Phone:717-730-8555
Practice Address - Fax:717-730-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006908-L103T00000X
PASW-000754-E1041C0700X
PAMD-057672L2084N0400X
PAMD-025872-E2084P0800X
PAMD-065197-L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty