Healthcare Provider Details

I. General information

NPI: 1831694116
Provider Name (Legal Business Name): WHOLELIFE INTEGRATIVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 VALLEY BROOK RD STE 206
MC MURRAY PA
15317-3428
US

IV. Provider business mailing address

6086 BROWNSVILLE ROAD EXT
FINLEYVILLE PA
15332-4121
US

V. Phone/Fax

Practice location:
  • Phone: 724-292-4751
  • Fax:
Mailing address:
  • Phone: 724-986-0479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. CHRISTINA PUCEL
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 724-986-0479