Healthcare Provider Details

I. General information

NPI: 1134851850
Provider Name (Legal Business Name): COUNSELING COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469 EVANS CITY ROAD
HARMONY PA
16037
US

IV. Provider business mailing address

2905 POINTE VIEW DR
MARS PA
16046-8937
US

V. Phone/Fax

Practice location:
  • Phone: 412-277-5622
  • Fax:
Mailing address:
  • Phone: 412-277-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GEMMA CARLINO
Title or Position: THERAPIST
Credential: LPC
Phone: 412-277-5622