Healthcare Provider Details

I. General information

NPI: 1740221076
Provider Name (Legal Business Name): WILLIAM GEORGE ALLENBAUGH II MA CAC LICENSED PSYC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MCCRACKEN RUN RD
DU BOIS PA
15801
US

IV. Provider business mailing address

170 MCCRACKEN RUN RD
DU BOIS PA
15801
US

V. Phone/Fax

Practice location:
  • Phone: 814-371-5565
  • Fax: 814-371-5679
Mailing address:
  • Phone: 814-371-5565
  • Fax: 814-371-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS007390L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPS007390L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: