Healthcare Provider Details

I. General information

NPI: 1679793525
Provider Name (Legal Business Name): REBECCA LYNN CHATLAS M.S., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA LYNN MANCHES

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S ARCH ST
CONNELLSVILLE PA
15425-3515
US

IV. Provider business mailing address

3 JACOB ST
UNIONTOWN PA
15401-3038
US

V. Phone/Fax

Practice location:
  • Phone: 724-626-9941
  • Fax: 724-626-2785
Mailing address:
  • Phone: 724-430-7275
  • Fax: 724-430-7275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004484
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: