PINEBROOK SERVICES FOR CHILDREN AND YOUTH (NPI# 1699847392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699847392 |
| Entity Type | Organization |
| Organization Name | PINEBROOK SERVICES FOR CHILDREN AND YOUTH |
| Other Organization Name | THE FLORENCE CHILD GUIDANCE CENTER |
| Practice Address |
402 N Fulton St Allentown PA 18102-2002 |
| Practice Telephone | 6104323919 |
| Practice Fax Number | 6104325174 |
| Mailing Telephone | 6104323919 |
| Mailing Fax Number | 6104325174 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT M JACOBS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6104323919 |
| Authorized Official Credential | MPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
204540 | PA | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
202970 | PA | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
203800 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CCBH | 1000570 | 01 |
| Other Name | Type Code |
|---|---|
| The Florence Child Guidance Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093990178 | Pinebrook Services for Children and Youth | Clinic/Center | 402 N Fulton St, Allentown, PA 18102-2002 | 2008-01-08 |
| 1457536534 | Pinebrook Services for Children and Youth | Clinic/Center | 402 N Fulton St, Allentown, PA 18102-2002 | 2008-01-08 |
| 1801071980 | Pinebrook Services for Children and Youth | Clinic/Center | 402 N Fulton St, Allentown, PA 18102-2002 | 2008-01-08 |
| Street Address |
402 N FULTON ST |
| City | ALLENTOWN |
| State | PA |
| Zip Code | 18102-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740709849 | Andrea Daniela Mancini | Social Worker | 402 N Fulton St, Allentown, PA 18102-2002 | 2017-09-11 |
| 1083095665 | Cassandra Spence | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-06-09 |
| 1518352137 | Charlene Holmes | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-31 |
| 1154714038 | Marissa Satterfield | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-16 |
| 1134512619 | Christine Fellin | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-09 |
| 1093108490 | Michelle Dianne Rodas | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-09 |
| 1376936831 | Megan Gabel | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-09 |
| 1497147342 | Beata Lazaro | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-03-02 |
| 1457742165 | Katie Ann Buzzard | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-02-17 |
| 1487045233 | Amanda Sue Jaeger | Counselor | 402 N Fulton St, Allentown, PA 18102-2002 | 2015-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548808363 | Katherine Camoni | Counselor | 451 West Chew St., Allentwon, PA 18102 | 2019-12-11 |
| 1346802931 | Kelly Alexander | Counselor | 451 W . Chew Street, Allentown, PA 18102 | 2019-07-03 |
| 1457910481 | Ayza Taimur | Internal Medicine | 1627 West Chew Street, 101, Allentown, PA 18102 | 2019-06-12 |
| 1972161602 | Emily Skutnik | Internal Medicine | Lvpp 1627 West Chew Street #101, Allentown, PA 18102 | 2019-05-29 |
| 1508336652 | Mercy A Gonzalez Devillacis | Counselor | 843 N . 6 Th St, Allentown, PA 18102 | 2018-12-03 |
| 1134611742 | Amanda Catherine Koziel | Family Medicine | 218 N. 2nd Street, Allentown, PA 18102 | 2018-05-31 |
| 1174981369 | Marcos Morales | Counselor | 462 W. Walnut Street, Allentown, PA 18102 | 2016-02-03 |
| 1740688423 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 451 W. Chew St., Suite 105, Allentown, PA 18102 | 2014-12-12 |
| 1982006250 | Martha Lebron | Nurse Practitioner | 451 Chew St Ste 400, Allentown, PA 18102 | 2014-09-18 |
| 1841699741 | Nicole Tennant | Physical Therapy Assistant | 613 W Allen St, Allentown, PA 18102 | 2014-08-15 |
| Find all providers in zip 18102 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932744513 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1430 W Allen St, Allentown, PA 18102-2146 | 2019-11-07 |
| 1447894589 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 137 N 2nd St, Allentown, PA 18101-1935 | 2019-11-01 |
| 1972147023 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 709 W Emaus Ave, Allentown, PA 18103-6778 | 2019-11-01 |
| 1942745138 | Pyramid Healthcare Inc | Clinic/Center | 106 N 17th St, Allentown, PA 18104-5673 | 2016-12-27 |
| 1639614142 | Pyramid Healthcare Inc. | Clinic/Center | 401 W Allen St, Allentown, PA 18102-2458 | 2016-12-20 |
| 1740688423 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 451 W. Chew St., Suite 105, Allentown, PA 18102 | 2014-12-12 |
| 1740824978 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 829 W Turner St, Allentown, PA 18102-4066 | 2019-10-31 |
| 1285276865 | Lehigh Valley Physician Group | Clinic/Center | 401 N 17th St Ste 203, Allentown, PA 18104-5050 | 2019-10-15 |
| 1588109771 | Pyramid Helathcare Inc. | Clinic/Center | 517 N 15th St, Allentown, PA 18102-2103 | 2016-12-27 |
| 1770028292 | Pyramid Healthcare Inc | Clinic/Center | 815 N Irving St, Allentown, PA 18109-1832 | 2016-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.