Healthcare Provider Details

I. General information

NPI: 1235063132
Provider Name (Legal Business Name): ELIZABETH MARIE CLEMENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N THOMPSON LN STE E
IRWIN PA
15642-9305
US

IV. Provider business mailing address

25 N THOMPSON LN STE E
IRWIN PA
15642-9305
US

V. Phone/Fax

Practice location:
  • Phone: 724-382-4941
  • Fax: 724-590-5121
Mailing address:
  • Phone: 724-875-5731
  • Fax: 724-590-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: