Healthcare Provider Details

I. General information

NPI: 1538560545
Provider Name (Legal Business Name): COUNSELING CORNER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S MAIN ST
CAMBRIDGE SPRINGS PA
16403-1140
US

IV. Provider business mailing address

222 S MAIN ST
CAMBRIDGE SPRINGS PA
16403-1140
US

V. Phone/Fax

Practice location:
  • Phone: 814-573-0993
  • Fax: 814-398-1019
Mailing address:
  • Phone: 814-573-0993
  • Fax: 814-398-1019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPA004533
License Number StatePA

VIII. Authorized Official

Name: MRS. DEBORAH M MARLOWE
Title or Position: OWNER
Credential: MA
Phone: 814-573-0993