Provider Demographics
NPI:1710779616
Name:THE CENTER FOR CHILD PSYCHOLOGY
Entity type:Organization
Organization Name:THE CENTER FOR CHILD PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAUVE
Authorized Official - Middle Name:ELIETH
Authorized Official - Last Name:YOUNG-MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:570-319-6961
Mailing Address - Street 1:411 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1837
Mailing Address - Country:US
Mailing Address - Phone:570-319-6961
Mailing Address - Fax:
Practice Address - Street 1:411 DAVIS ST
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1837
Practice Address - Country:US
Practice Address - Phone:570-319-6961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty