Healthcare Provider Details

I. General information

NPI: 1700726445
Provider Name (Legal Business Name): MADISON JOYCE PASTORE LAPC, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018 ROUTE 130
IRWIN PA
15642-7830
US

IV. Provider business mailing address

4018 ROUTE 130
IRWIN PA
15642-7830
US

V. Phone/Fax

Practice location:
  • Phone: 724-216-3358
  • Fax:
Mailing address:
  • Phone: 724-216-3358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC002269
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: