Healthcare Provider Details

I. General information

NPI: 1366863870
Provider Name (Legal Business Name): CLARION FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22868 ROUTE 68 SUITE 5
CLARION PA
16214-8566
US

IV. Provider business mailing address

22868 ROUTE 68 SUITE 5
CLARION PA
16214-8566
US

V. Phone/Fax

Practice location:
  • Phone: 814-227-2941
  • Fax: 814-227-2946
Mailing address:
  • Phone: 814-227-2941
  • Fax: 814-227-2946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SONDRA NOLF
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-227-2941