BERKS THERAPEUTIC ALLIANCE NPI 1497167167

NPI Information

  • NPI: 1497167167
  • Provider Name: BERKS THERAPEUTIC ALLIANCE
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Other Name: KEYSTONE BLUE HEN PC
  • Address: 845 N PARK RD
    SUITE 101
    WYOMISSING, PA
    ZIP 19610
  • Phone: (610) 334-8131

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NPI Details

BERKS THERAPEUTIC ALLIANCE is an addiction (substance use disorder) counselor in Wyomissing, PA. BERKS THERAPEUTIC ALLIANCE NPI is 1497167167. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Keystone Blue Hen Pc.

The provider's business location address is:

845 N PARK RD
SUITE 101
WYOMISSING, PA
ZIP 19610-342
Phone: (610) 334-8131

The provider's authorized official is Scot Mason Depue .
The authorized official title is Ceo and has the following contact phone number (484) 769-7626.

The enumeration date for this NPI number is 5/28/2014 and was last updated on 5/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)PC002868PENNSYLVANIANo
2207P00000XEmergency MedicineMD426302PENNSYLVANIANo
3101YA0400XCounselorAddiction (Substance Use Disorder)MD426302PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F52533MEDICARE UPINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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