Organization · Type 2 NPI

Children's Service Center of Wyoming Valley, Inc

Federally Qualified Health Center (FQHC) · Wilkes Barre, PA

NPI number 1710617857 Active

Practice location

335 S Franklin St Bldg A
Wilkes Barre, PA 18702-3808

Call (570) 301-0924 Map

Mailing address

335 S Franklin St
Wilkes Barre, PA 18702-3808

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Pediatrics Physician	208000000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

Azam Mashayekhi, CRNP-FHFamily Nurse Practitioner Wilkes Barre, PA NPI 1396655288
David A. Wood, DOFamily Medicine Physician Wilkes Barre, PA NPI 1447202395

Other federally qualified health center (fqhc) providers in Wilkes Barre

See all in Wilkes Barre →

NPI record

NPI: 1710617857
Entity type: Organization (Type 2)
Issued: Jun 13, 2022
Last updated: Aug 12, 2026
Status: Active
Subpart: Yes of Children's Service Center of Wyoming Valley Inc

Other names

Conyngham Primary Health Care Center · other name

Authorized official

Sharon Vivian
CFO
(570) 825-6425

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1710617857

Children's Service Center of Wyoming Valley, Inc's National Provider Identifier is 1710617857, issued on Jun 13, 2022. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Wilkes Barre, PA. The record was last updated on Aug 12, 2026.