Healthcare Provider Details

I. General information

NPI: 1508801887
Provider Name (Legal Business Name): PAOLETTA COUNSELING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 N PITT ST
MERCER PA
16137-1129
US

IV. Provider business mailing address

456 N PITT ST
MERCER PA
16137-1129
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-7202
  • Fax:
Mailing address:
  • Phone: 724-662-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number437940
License Number StatePA

VIII. Authorized Official

Name: MS. DAWN R HANAWAY
Title or Position: CEO
Credential: MED
Phone: 724-662-7202