Healthcare Provider Details

I. General information

NPI: 1902400955
Provider Name (Legal Business Name): CLARISSA ARBUCKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 09/11/2025
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60B FRANKLIN RD
MERCER PA
16137-5118
US

IV. Provider business mailing address

462 CARPENTERS CORNERS RD
CLARKS MILLS PA
16114-1902
US

V. Phone/Fax

Practice location:
  • Phone: 724-269-7222
  • Fax:
Mailing address:
  • Phone: 724-253-4276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: