Provider Demographics
NPI:1699739631
Name:MT. CARMEL MENTAL HEALTH CONSULTANTS, P.C.
Entity type:Organization
Organization Name:MT. CARMEL MENTAL HEALTH CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PA LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:570-339-1828
Mailing Address - Street 1:129 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MT CARMEL
Mailing Address - State:PA
Mailing Address - Zip Code:17851-2175
Mailing Address - Country:US
Mailing Address - Phone:570-339-1828
Mailing Address - Fax:570-339-1924
Practice Address - Street 1:129 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MT CARMEL
Practice Address - State:PA
Practice Address - Zip Code:17851-2175
Practice Address - Country:US
Practice Address - Phone:570-339-1828
Practice Address - Fax:570-339-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006073L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010079300001Medicaid
PAMT1541777OtherGROUP