Provider Demographics
NPI:1952652554
Name:BEHAVIORAL HEALTH PC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH PC
Other - Org Name:ALLIED BEHAVIORAL CLINICIANS 2667429
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:717-796-6550
Mailing Address - Street 1:1229 SCENERY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-796-6550
Mailing Address - Fax:717-796-6551
Practice Address - Street 1:1229 SCENERY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-796-6550
Practice Address - Fax:717-796-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2667429101Y00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07633599Medicaid
PA680011956OtherRAILROAD MEDICARE
PA030520Medicare PIN
PA07633599Medicaid