Healthcare Provider Details

I. General information

NPI: 1396049151
Provider Name (Legal Business Name): SUSAN M KOVAL M.A., NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3764 STATE ROUTE 711
LIGONIER PA
15658-5000
US

IV. Provider business mailing address

3764 STATE ROUTE 711
LIGONIER PA
15658-5000
US

V. Phone/Fax

Practice location:
  • Phone: 724-331-3925
  • Fax:
Mailing address:
  • Phone: 724-331-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPA006023
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: