Provider Demographics
NPI:1710910310
Name:BEAVER COUNTY PSYCHIATRIC SERVICES, PC
Entity Type:Organization
Organization Name:BEAVER COUNTY PSYCHIATRIC SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VOGEL-SCIBILIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-775-9150
Mailing Address - Street 1:219 THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009
Mailing Address - Country:US
Mailing Address - Phone:724-775-9150
Mailing Address - Fax:724-775-9153
Practice Address - Street 1:219 THIRD STREET
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009
Practice Address - Country:US
Practice Address - Phone:724-775-9150
Practice Address - Fax:724-775-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA663929OtherBLUE SHIELD
PA1249301Medicaid
PACI4079OtherRAILROAD MEDICARE
PA879856OtherBLUE SHIELD
PA632129OtherBLUE SHIELD
PA632129OtherBLUE SHIELD