Healthcare Provider Details

I. General information

NPI: 1841850492
Provider Name (Legal Business Name): COUNSELING CONNECTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22868 ROUTE 68
CLARION PA
16214-8566
US

IV. Provider business mailing address

1739 OLD FRYBURG RD
LUCINDA PA
16235-2519
US

V. Phone/Fax

Practice location:
  • Phone: 814-229-7711
  • Fax:
Mailing address:
  • Phone: 814-229-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JESSICA EISENMAN
Title or Position: OWNER
Credential:
Phone: 814-229-7711