Provider Demographics
NPI:1548351836
Name:CHILD, ADULT & FAMILY PSYCHOLOGICAL CENTER, P.C.
Entity type:Organization
Organization Name:CHILD, ADULT & FAMILY PSYCHOLOGICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHISWICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:814-234-3010
Mailing Address - Street 1:315 S ALLEN ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4849
Mailing Address - Country:US
Mailing Address - Phone:814-234-3010
Mailing Address - Fax:814-234-2170
Practice Address - Street 1:315 S ALLEN ST
Practice Address - Street 2:SUITE 218
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4849
Practice Address - Country:US
Practice Address - Phone:814-234-3010
Practice Address - Fax:814-234-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty