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Contact Information

LYCOMING COUNTY CRIPPLED CHILDREN'S
625 W EDWIN ST
WILLIAMSPORT, PA17701
 Phone: 570-326-0565
 Fax: 570-329-2522
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Neuropsychologist

103G00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LYCOMING COUNTY CRIPPLED CHILDRENS · (Female)

NPI Number 1104970227
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2007
Last updated 09/28/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • PA License # OC006418L
  • PA License # PS005489L
  • PA License # PT000490E
  • PA License # PT002737L
  • PA License # PT016332L
  • PA License # SL000825L
  • PA License # SL002712L
  • PA Medicaid 100004601
  • PA Medicaid 1000046010005
  • PA Other 43093 GEISINGER HEALTH PLAN
  • PA Other 000999239 HIGHMARK BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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