Healthcare Provider Details

I. General information

NPI: 1821969353
Provider Name (Legal Business Name): MCDONOUGH COUNSELING & COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 E DRINKER ST
DUNMORE PA
18512-2549
US

IV. Provider business mailing address

2126 JEFFERSON AVE
DUNMORE PA
18509-1527
US

V. Phone/Fax

Practice location:
  • Phone: 570-561-6504
  • Fax:
Mailing address:
  • Phone: 570-561-6504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PATRICK MCDONOUGH
Title or Position: OWNER/PROVIDER
Credential: LCSW
Phone: 570-561-6504