Healthcare Provider Details

I. General information

NPI: 1760469365
Provider Name (Legal Business Name): DARYL HLAVSA M.S., ATR-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HARTMAN ROAD BOX 12
GREENSBURG PA
15601-6920
US

IV. Provider business mailing address

125 HARTMAN ROAD BOX 12
GREENSBURG PA
15601-6920
US

V. Phone/Fax

Practice location:
  • Phone: 724-972-1242
  • Fax: 724-238-1828
Mailing address:
  • Phone: 724-972-1242
  • Fax: 724-238-1828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC001532
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: